Nasal tip refinement remains a cornerstone of successful rhinoplasty, requiring a balance between aesthetic goals and structural integrity. This review synthesizes contemporary literature from 2020 to 2026, focusing on the transition from reductive maneuvers to structural and preservation-based techniques. We analyze the efficacy of septocolumellar anchorage sutures, the strategic application of infratip strut grafts, and the clinical outcomes of ligament preservation. By integrating findings from systematic reviews and long-term cohort studies, this paper identifies a clear trend toward "tip tensioning" and hybrid algorithms. The results suggest that while sutures provide dynamic control, preservation of the native ligamentous network is critical for long-term stability. This review provides a comprehensive framework for surgeons to navigate current techniques and identifies gaps in high-level evidence regarding long-term aesthetic sustainability.
Serrano et al. (2026) studied this question.