How is it decided if a shield graft is needed for the tip? Is a shield graft effective?

A shield graft is a piece of cartilage cut into the shape of a shield that is placed on the lower lateral cartilages of the nasal tip as one of the final steps of a rhinoplasty, when needed.  The surgeon can elect to use a shield graft when the nasal tip is bulbous, needs additional definition, and there is sufficient remaining cartilage to make the graft.  The thickness of the nasal skin is also a factor in how much of an effect a shield graft can have on the appearance of the nose.  It is difficult to comment whether this would be an effective maneuver for your nose without photographs.  I would recommend an in-person consultation so that a surgeon can
thoroughly examine the inside and outside of your nose from different angles,
feel the tissues, better understand your goals, and make more specific
recommendations to achieve the natural look your desire.
Ziyad Hammoudeh, MD

Shield grafts can be excellent choices for tip augmentation. They can be used to add projection, fill defects and shape the tip. I often use them in conjunction with other graft types. Without a careful examination it is worthless to give specific recommendations concerning graft choices.