Septal extension grafts play a pivotal role in controlling nasal tip projection and rotation in rhinoplasty. Achieving ideal nasal tip positioning is essential for facial harmony and patient satisfaction. This can be accomplished by balancing nasal length, projection, and rotation. Septal extension grafts, typically harvested from the patient’s own septal cartilage, offer a reliable method for extending the caudal septum and reinforcing nasal tip support. They are commonly preferred due to their structural strength and versatility. This panel will explore the various types of septal extension grafts, their design options, and indications. Practical considerations, including patient selection, surgical technique, and complications, will also be discussed. Emphasis will be placed on integrating functional and aesthetic outcomes through evidence-based practices. Participants will gain insight into optimizing nasal tip outcomes using different graft configurations in diverse clinical scenarios.