Successful rhinoplasty requires a detailed understanding of the nasal structure needed to produce a functional and aesthetically pleasing nose. Recent advances in surgical technique have focused on cartilage repositioning and reshaping, often with the use of cartilage grafting.Newer techniques for strengthening the middle vault, stabilizing the base, and modifying the lateral crura are presented, as well as the M-arch model, a modification of the tripod concept.Technical advances in rhinoplasty provide numerous options for reconstruction and reshaping of the nose.