I have completed two Surgical residencies, one in General Surgery, and the other in Plastic and Reconstructive surgery. I am half Asian, and my wife is Asian. Furthermore, I have performed both cosmetic Rhinoplasty and reconstructive Rhinoplasty (nose surgeries) as well as cosmetic Otoplasty and reconstructive Otoplasty. This gives me a very good perspective from which to respond to your question. While traditional surgical approaches to asian rhinoplasty often used cartilage to support the tip via a columella strut, and to raise the dorsum via a dorsal graft, the logical choice for options would look to the septum first. It is a good source for cartilage grafts, is loco regional to the anatomic surgical area, and very often improves the airway for the patient (especially if there is pre-existing septal deviation. Conchal grafts harvested from the ear are another option for autologous cartilage grafts, however they tend to be curved by require careful selection and carving to create a structurally appropriate graft. Rib cartilage is almost universally reserved for TRUE NASAL RECONSTRUCTION, and even then in younger patients with more pliable cartilage. As we age, the cartilage ossifies and becomes harder and more brittle, rendering it less receptive to the passage of needles and the placement of sutures. That being said, MANY asian rhinoplasty cases can be performed with one of TWO modern, MINIMALLY INVASIVE modalities. A silastic (silicone) implant can be placed as a columella strut, and the dorsum can be augmented with a filler such as Radiesse. Alternatively, a combined columella and dorsal (L shaped) implant can be placed eliminating the need for filler. The first procedure is less invasive than the second, and BOTH can be done under local anesthesia. As with any surgical procedure, sterility is paramount, but particularly so in this region given the very thin overlying skin. In addition, the dorsal strut should be placed in a SUBPERIOSTEAL pocket, to reduce the pressure on the overlying skin, to maintain control of the implant position and minimize movement, and to reduce the risk of infection.While these procedures are conceptually very simple, they should ONLY be performed by experienced surgeons who understand YOUR goals, YOUR anatomy, and the technical aspects of your procedure.