Aesthetic Rhinoplasty

Aesthetic rhinoplasty requires a detailed understanding of nasal anatomy, structural support, and airway preservation to achieve balanced functional and aesthetic outcomes. Contemporary techniques emphasize individualized preoperative analysis, conservative modification of the osseocartilaginous framework, and preservation of nasal support mechanisms. Here we describe a systematic approach to primary open rhinoplasty, including preoperative assessment, operative planning, septoplasty, dorsal modification, osteotomies, tip refinement, grafting strategies, and postoperative management. Key concepts include maintenance of the septal L-strut, preservation of the internal nasal valve, controlled osteotomies, and structural tip support through grafting and suture techniques. Commonly utilized grafts, including spreader grafts, columellar strut grafts, subdomal grafts, onlay domal grafts, and alar rim grafts, are discussed in the context of functional support and aesthetic contouring. Postoperative splinting, edema management, and longitudinal follow-up are also reviewed. A structured and anatomy-based approach to rhinoplasty allows for predictable aesthetic refinement while maintaining long-term nasal function and structural stability.