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Objective To explore the clinical application of "cruciform" ear cartilage scaffold and alar groove plasty in tip rhinoplasty. Methods In a retrospective study from January 2014 to December 2017, 37 patients underwent dorsum and tip augmentation with alar grove plasty using the technique. All patients underwent primary augmentation rhinoplasty or a second revision following a simple silicone implant to the dorsum. During the operation, a silicone implant was used for dorsum augmentation. Autologous ear cartilage was harvested and dissected to form a "cruciform" cartilage scafford for tip augmentation. The subcutaneous tissue under desired alar groove area was properly thinned to allow reattachment under percutaneous trans-fixation for 4 to 7 days. Results All patients the postoperative results were mainly satisfying with tip augmentation and a better-defined alar grove. Postoperative courses were uncomplicated during a 6 to 24 months follow-up without tip extrusion, infection, and graft shifting. Conclusion The combined technique is safe and effective in nasal dorsum and tip augmentation with alar grove improvement. It defines the tip and the alar groove area while minimizing the risk of early stage graft shifting in a relatively simple and less invasive way, postoperative appearance is better than before. [ABSTRACT FROM AUTHOR]