Nasal tip surgery is regarded as the most challenging aspect of plastic surgery. No routine tip procedure is ever used. Nasal tip harmony improves its visual appeal. Aim of the work is to study and implement the different surgical treatment options for the management of the various nasal tip deformities with special emphasis placed on the effect of each suture on the three-dimensional configuration of the nasal tip. Nasal surgical procedures frequently involve manipulation of the lower lateral cartilages, and the sutures placed to alter these cartilages are critical components of current tip surgical procedures. Patients and methods: 30 Patients with various tip deformities were operated upon through an open or closed approach accompanied by either sutures (20 cases), and combined suturing and grafts (10 cases). Conclusion: management of nasal tip deformities with various suturing techniques is an effective nondestructive tool in recent nasal tip plasty for most cases. However, certain cases including cleft lip nose, negroid features, posttraumatic and redo rhinoplasty usually require combined techniques to provide the optimum cosmetic results.