Background <p>After nasal reconstruction, a nostril retainer may be used to maintain an open airway, protect and support tissues, and prevent tissue contraction. The postoperative use of a nostril retainer has been suggested as a solution to maintain the corrected nostril contour. This study aimed to evaluate the effect of nostril retainer use on nostril shape changes after rhinoplasty.</p> Methods <p>A retrospective cohort study included 60 primary rhinoplasty patients: 30 rhinoplasty patients who used a nostril retainer (NR) and 30 rhinoplasty patients who did not use a nostril retainer (NoNR). Functional and aesthetic outcomes were assessed using pre- and postoperative NOSE and FACE-Q scores. Pre- and postoperative frontal, right lateral, and basal photographs of the patients were analyzed using the <i>Rhinobase Software Photos</i> program.</p> Results <p>Both groups were similar in age, gender, and follow-up time. Preoperative and postoperative NOSE scores were similar in both groups. The preoperative FACE-Q score was also comparable between groups. However, the postoperative FACE-Q score in the NoNR group was significantly lower than that in the NR group (<i>p</i> = 0.006). Alar width was narrower in the NR group.</p> Conclusions <p>Using a nostril retainer postoperatively can help maintain nasal contour and improve aesthetic results.</p> Level of evidence <p>Level III, therapeutic study.</p>