Background <p>Augmentation rhinoplasty surgery is an amalgamation of art and science where cosmetic improvement runs parallel with improved nasal breathing. The aim of our study was to analyse various graft materials used in augmentation rhinoplasty and to assess their surgical outcome. It was a prospective observational study over a period of two years during which all patients with depressed nasal dorsum were included. The graft materials used were bone, cartilage, and silicone implants. Objective and subjective outcomes were assessed by using separate satisfaction scores for patients and doctors.</p> Results <p>For assessment of results, comparison of satisfaction scores of patients (external nasal shape improvement and relief of discomfort) and doctors (photographic improvement and increase in height of dorsum) with respect to graft materials used and surgical outcome were analysed by analysis of variance (ANOVA). The score was graded from 1 (very dissatisfied), 2 (dissatisfied), 3 (fair), 4 (satisfied) and 5 (very satisfied). A statistically significant (p &lt; 0.05) association was found between the doctor satisfaction score and the type of graft used. However, patient satisfaction score was not associated with the type of graft used in our study.</p> Conclusions <p>Autologous cartilage grafts are better because of their optimal vascularity, biocompatibility and longevity. Surgical technique should be customised as per the patient’s cosmetic and nasal airway requirements because satisfaction does not improve with the type of graft used alone. Overall patient satisfaction is higher in cases where both form and functional improvement are significant, which is the subject for future research.</p>