Background <p>Nasal tip management is challenging. The ANSA (Anterior Nasal Septal Angle) graft, a partial septal extension graft, provides support and maintains the desired projection and rotation. The objective of this study was to evaluate the long-term reliability of the ANSA banner graft in open septorhinoplasty and to determine patient satisfaction.</p> Methods <p>We performed a retrospective cohort study of patients operated on at the ENT Department of a fourth-level care hospital between January 2020 and December 2023. Full profile photographs were analyzed at three time points: preoperative, immediate postoperative (1–7 months), and distant postoperative (10–17 months). The Rhinoplasty Outcome Evaluation (ROE) satisfaction survey was administered.</p> Results <p>Surveys from 46 patients were analyzed, yielding a 55.75% satisfaction with the surgery. The photographic group included 17 women (mean age 27.5 ± 8.1 years). The Goode index, Rohrich index, and nasolabial angle were measured. Statistical analysis showed significant differences in rotation between preoperative and immediate postoperative periods (<i>p</i> &lt; 0.001), and between preoperative and distant periods (<i>p</i> &lt; 0.001), with no differences between remote and distant periods (<i>p</i> = 0.487), indicating stability over time. Nasal projection did not show significant variations.</p> Conclusion <p>The ANSA graft allows a long-term maintenance of nasal tip rotation, with projection stability. In our series, the clinical results and satisfaction surveys support its usefulness as a safe and effective technique in open septorhinoplasty. Level of Evidence: Level III, risk/prognostic study.</p>