Abstract
Rhinoplasty has evolved into a sophisticated, multifunctional discipline that harmonizes aesthetic refinement with airway preservation. This narrative review synthesizes contemporary rhinoplasty practices across four major domains: structural surgery, preservation and hybrid approaches, grafting and dorsal augmentation, and nonsurgical nasal reshaping. Emphasizing method-level detail and emerging technologies—such as piezoelectric osteotomy, platelet-rich fibrin (PRF), and three-dimensional planning—the article examines key surgical paradigms including open and endonasal structural rhinoplasty, dorsal preservation techniques, and minimally invasive refinements. It further discusses grafting materials, from autologous cartilage to alloplastic implants and biologic adjuncts, and evaluates the expanding role of nonsurgical modalities such as hyaluronic acid fillers, threads, and fat grafting. Despite advances in technique and technology, the evidence base remains dominated by case series and expert opinion, highlighting the need for prospective comparative studies, standardized outcome metrics, and enhanced safety reporting. The review concludes that a patient-specific, hybridized approach—integrating structural, preservation, and nonsurgical elements—offers the most rational pathway to consistent, durable, and natural outcomes in modern rhinoplasty.