Objective To explore the effect of autologous nasal septal cartilage transplantation in plastic surgery for nasal tip hypertrophy. Methods A total of 92 patients with nasal tip hypertrophy admitted to the Department of Plastic Surgery, Xiamen Siming Huamei Medical Cosmetology Clinic from January 2023 to June 2024 were selected as the research subjects, and they were divided into the reference group (46 patients) and the study group (46 patients) according to the random number table method. The reference group was treated with expanded prosthesis transplantation, and the study group was treated with autologous nasal septal cartilage transplantation. The nasal aesthetic shaping indicators, nasal physiological function indicators, complications and plastic surgery satisfaction were compared between the two groups. Results After treatment, all nasal aesthetic shaping indicators in the study group were higher than those in the reference group, and nasal resistance and nasal ciliary movement rate were better than those in the reference group (P <0.05). The incidence of complications in the study group (4.35%) was lower than that in the reference group (17.39%), and plastic surgery satisfaction was higher than that in the reference group (P <0.05). Conclusion The application of autologous nasal septal cartilage transplantation in plastic surgery for nasal tip hypertrophy can effectively improve the nasal tip status of patients and achieve more ideal aesthetic shaping effects. At the same time, it will not cause adverse effects on patients' nasal function, reduce the incidence of related complications, and improve patient satisfaction.