Asian rhinoplasty often adopts new materials without sufficient evidence, risking patient safety. Overconfidence in alloplastic implants, even on osteotomized bones, overlooks serious complications. The belief that septorhinoplasty is inherently clean underestimates its risks, especially with empirical antibiotic use. In secondary cases, autologous grafts are crucial for soft tissue, framework, and functional repairs. Reconstructing the septal L-strut with autografts minimizes reliance on implants, preserving nasal integrity and offering a reliable, evidence-based approach to Asian rhinoplasty challenges.