Objective To explore the effect of alar rim graft placement in rhinoplasty on shaping effect and nasal physiological function. Methods A total of 78 patients undergoing rhinoplasty admitted to Beijing Meiyi Xibahe Medical Cosmetology Hospital from February 2023 to February 2024 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 39 patients in each group. The control group was given rhinoplasty without alar rim graft placement, and the observation group was given rhinoplasty with alar rim graft placement. The shaping effect, nasal physiological function, nostril axis distance ratio, appearance satisfaction and complications were compared between the two groups. Results The nasal length, nasal tip height and distance between two nasal tip apices in the observation group after operation were better than those in the control group (P <0.05). The nasal ciliary movement rate and nasal resistance in the observation group after operation were better than those in the control group (P <0.05). The nostril axis distance ratio and appearance satisfaction score in the observation group after operation were better than those in the control group (P <0.05). The incidence of complications in the observation group was 7.69%, which was higher than 5.13% in the control group, but the difference was not statistically significant (P >0.05). Conclusion The application of alar rim graft placement in rhinoplasty can help to improve the shaping effect, enhance nasal physiological function, and optimize nostril axis distance ratio and appearance satisfaction, without increasing the incidence of complications.