At times, a small segment of cartilage may be excised from the lateral crura, or the cartilage may be overlapped and sutured. This provides added control over projection and rotation while simultaneously achieving nasal tip refinement. A number of grafts may be applied in the nasal tip, depending upon the anatomy and goals of surgery. Advantages of cartilage grafting techniques include strengthening of the tip and reversibility of techniques. Autologous cartilage generally is the preferred grafting material.
Septal cartilage is the most commonly used autologous grafting material in the nasal tip.
Conchal cartilage frequently is used when its shape is preferred or when septal cartilage is unavailable. Rib cartilage is another autologous grafting alternative. Irradiated rib cartilage is a nonautologous alternative. Alloplastic materials should be avoided in the nasal tip because the nasal tip is too mobile and too exposed to reliably tolerate artificial materials for a lifetime. Lateral crural strut grafts, as described by Gunter, are underlay grafts placed beneath the lateral crus.