Objective To analyze the effect of autologous bilateral auricular concha cartilage modified scaffold rhinoplasty on aesthetics in rhinoplasty patients. Methods A total of 60 patients who underwent rhinoplasty in Hangzhou Milan Bravou Medical Cosmetology Hospital from January to December 2023 were selected as the research subjects, and they were divided into the reference group and the study group by the random number table method, with 30 patients in each group. The reference group received autologous nasal septal cartilage scaffold rhinoplasty, and the study group received autologous bilateral auricular concha cartilage modified scaffold rhinoplasty. The aesthetics, surgical satisfaction score and complications were compared between the two groups. Results The nasal tip height, overall nasal length, nasal tip projection, nasofrontal angle and nasolabial angle in the study group were better than those in the reference group (P <0.05). The ROE score in the study group was higher than that in the reference group (P <0.05). The incidence of complications in the study group was 3.33%, which was lower than 26.67% in the reference group (P <0.05). Conclusion Autologous bilateral auricular concha cartilage modified scaffold rhinoplasty has a definite effect, which can improve patients' nasal aesthetics and satisfaction, with high safety and high application value.