Structural Nasal Tip Grafting: Anatomy, Evaluation, and Technique Selection for Durable Aesthetic and Functional Outcomes.

[AIMS AND BACKGROUNDS] This study aims to review contemporary principles of structural nasal tip grafting and provide a practical framework for selecting techniques that achieve durable aesthetic and functional outcomes.

[HISTORICAL ASPECTS] We summarize the evolution from reduction rhinoplasty toward preservation and structural approaches that prioritize long-term tip support.

[ANATOMY] Key osteocartilaginous and soft tissue support mechanisms of the nasal tip are outlined with emphasis on major and minor tip support structures.

[TECHNOLOGY] Open and endonasal approaches, autologous cartilage sources, and ancillary materials such as fascia are described as tools to modify tip contour and support.

[PATIENT SELECTION] Clinical assessment focuses on skin-soft tissue envelope, cartilage strength, airway function, and dynamic deformities.

[TECHNIQUES] Stepwise algorithms for columellar strut and septal extension grafts, plumping grafts, alar rim and batten grafts, lateral crural struts, shield and cap grafts, and articulated alar rim grafts are presented.

[POST OPERATIVE CARE] Postoperative management to protect graft position and control edema is reviewed.

[CURRENT AND FUTURE DEVELOPMENT] Emerging trends toward individualized, data-informed rhinoplasty and objective outcomes assessment are discussed.

[CONCLUSIONS AND CLINICAL RELEVANCE] Thoughtful selection and execution of structural tip grafts allow surgeons to achieve stable, reproducible tip shape while optimizing nasal airway function.