Old rhinoplasty practice has been often relied on resection of the nasal framework in order to achieve aesthetic and/ or functional objectives. Nowadays, careful dissection, conservative resection, planned framework remodeling, & judicious use of properly selected grafts for augmentation comprise the basis for a structural approach to grafting in rhinoplasty. Aim of the work is to present and evaluate outcomes of using grafts in rhinoplasty. Grafts types, techniques were reviewed. Complications, if encountered, were mentioned. Patient satisfaction was evaluated. Methodology is a prospective study utilized the open rhinoplasty technique, upon 35 patients that suffered from various nasal deformities. Their ages ranged between 18 and 45 years. The followed principles consisted of: 1) A precise definition of the type and cause of abnormality. 2) Definition of the goals. 3) Adequate exposure. 4) Preservation or restoration of normal anatomy 5) Incremental and planned correction. 6) Maintenance of nasal airway. Results are 35 patients operated by the open technique, 23 were males while 12 were females. Of them, 32 cases were fully corrected while, 3 cases were partially corrected. Complications were minimal, occurred in 3 cases. The majority of cases (32 cases) were satisfied while 3 cases were unsatisfied. Conclusion is development of sophisticated grafting techniques has played an integral role in achieving durable aesthetic and functional surgical outcomes in rhinoplasty.