The chapter critically examines the complexity of Asian rhinoplasty, pointing out the excessive dependence on synthetic implants for nasal enhancement and advocating for reconsidering adopting a septal L-strut extension graft. It draws attention to the unique challenges in revision surgeries due to scar tissue, which is less prevalent in Western procedures. It debates the suitability of modern rhinoplasty trends in Asia due to anatomical distinctions. The text favors targeted reduction techniques over general hump removal and disapproves of the overuse of synthetic materials for augmenting the lower two-thirds. It also discusses the risk of surgical complications and emphasizes the need for careful dorsal implanting over a fragile framework. While silicone and Gore-Tex provide easy dorsal lines, autogenous grafts offer superior natural appearance, necessitating a paradigm shift. Strategic graft placement ensures stability, with AESG elevation enhancing cartilaginous dorsum and CSEG providing fixation.