The addition of cartilage in the nose, cartilage grafting, is an important tool for reshaping the nasal tip. The open technique allows precise placement and suture stabilization of these grafts. The preferred source of cartilage for the grafts is the nasal septum; this involves removing a non-structural component of the septum and creating the grafts from it. We can use auricular (ear) or costal (rib) cartilage when there is an inadequate source of septal cartilage (usually because of patients having prior septoplasty and/or rhinoplasty surgery).