Objective. To describe surgical techniques using various cartilage tip grafts for satisfactory long-term aesthetic results of correction.

Material and methods. There were 350 patients with congenital and acquired deformities of external nose of different age groups and ethnicities between November 2022 and November 2023. We analyzed the features of skin anatomy and physiology in each case and created the most suitable modifications of cartilage tip graft. These patients underwent open and closed rhinoplasty. Mean age of patients was 37.5 years (range 18—57). We used various grafts from nasal septum or costal cartilage in primary or reconstructive rhinoplasty to form a beautiful nasal tip with necessary height, shape and width. The following grafts were used: solid rigid rectangular fragment of cartilage with preserved corners, without corners, with softened corners, solid softened rectangular graft, combined graft (rigid one with corners and softened one expanding like a truncated pyramid).

Results. There were no early and late postoperative complications. Aesthetic parameters of shape, width and height of nasal tip were achieved. The result scheduled at the preoperative stage was obtained.

Conclusion. The outcomes of rhinoplasty largely depend on baseline anatomy of the nose, type, thickness and structure of skin, number of sebaceous glands and subcutaneous fat. The proposed variations of tip graft transformation contribute to harmonious and elegant profile with stable and “wearable” results in delayed postoperative period.

Keywords. rhinoplasty, tip grafts, septal cartilage, costal cartilage