Objective To investigate the therapeutic effect and safety of autologous auricular cartilage transplantation combined with solid silicone prosthesis implantation in rhinoplasty. Methods A total of 84 patients who underwent rhinoplasty in our hospital from March 2022 to October 2023 were selected for study. According to the random number table method, they were divided into reference group and study group, with 42 patients in each group. The reference group was treated with simple silicone prosthesis, and the study group was treated with autologous auricular cartilage transplantation combined with solid silicone prosthesis implantation. The surgical indexes, therapeutic effects and complications were compared between the two groups. Results The nasal tip elongation of the study group was higher than that of the reference group, and the incision healing time was less than that of the reference group, the difference were statistically significant (P <0.05). There was no significant difference in operation time between the two groups (P >0.05).The total effective rate of treatment in the study group was 95.24%, which was higher than 78.57% in the reference group, the difference was statistically significant (P <0.05). The incidence of complications in the study group was 2.38%, which was lower than 16.67% in the reference group, the difference was statistically significant (P <0.05). Conclusion Autologous auricular cartilage transplantation combined with solid silicone prosthesis implantation in rhinoplasty can achieve more ideal curative effect and higher safety.