AbstractObjective:To validate the use of the conchal cartilage butterfly graft in primary functional rhinoplasty and to review our experience using this technique.Study Design:A retrospective analysis of patients who underwent conchal cartilage butterfly graft reconstruction of the nasal valve in primary rhinoplasty.Method:A retrospective analysis using patient questionnaires was performed. Data were collected to determine patient satisfaction about nasal breathing and cosmesis after the procedure.Results:Among the patients, 90% (n = 90) had improved breathing, 88% (n = 88) were satisfied with their postoperative cosmesis, and 89% said they would recommend the procedure to a friend who had similar preoperative symptoms.Conclusion:Conchal cartilage butterfly graft has now been shown to be successful in primary functional rhinoplasty, just as it has previously been proven effective in secondary rhinoplasty. Although we have had success with many techniques for the correction of internal nasal valve collapse, we have found the conchal cartilage butterfly graft to be another outstanding technique for the appropriately selected patient. Laryngoscope, 2009