The nasal tip projection consists of the length and strength of lower lateral cartilages, the suspensory ligament, fibrous connections to the upper lateral cartilages, and the anterior septal angle [1]. Several cartilage grafts have been described to alter nasal tip projection and rotation. Columellar struts and septal extension grafts are both commonly used in modern rhinoplasty to adjust nasal tip projection and rotation [2].

The use of septal extension grafts is particularly beneficial for patients with a weak or under-projected nasal tip, which can be caused by a variety of factors including genetics, trauma, aging, or previous nasal surgery. By extending the septum and providing support to the nasal tip, a septal extension graft can create a more defined and aesthetically pleasing nasal tip [3]. In addition to enhancing the appearance of the nose, septal extension grafts can also help to improve nasal breathing. The graft provides support to the nasal tip, which can help to prevent collapse of the nostrils during inhalation and improve airflow through the nasal passages.

The use of spreader grafts is particularly beneficial for patients with a deviated septum, narrow nasal passages, or a depressed mid-nasal vault. By widening the dorsal nasal septum, a spreader graft can help to improve nasal breathing and create a more aesthetically pleasing nose [2], [3].

The aim of this study was to demonstrate the use of the hammer graft, which is a cartilaginous graft that provides nasal tip projection and rotation, supports the caudal part of the septum, as well as nasal dorsal stabilization in one piece, in rhinoplasty cases.