Objective To explore the cosmetic effect of autologous costal cartilage scaffold in nasal comprehensive plastic surgery and its influence on patients' satisfaction with plastic surgery. Methods A total of 100 people who underwent comprehensive rhinoplasty in Shanghai Yiyan Medical Cosmetic Clinic from January 2020 to December 2021 were selected as the research objects. They were divided into control group and observation group by random number table method, with 50 patients in each group. The control group was treated with comprehensive rhinoplasty using autologous ear cartilage scaffold, and the observation group was treated with comprehensive rhinoplasty using autologous costal cartilage scaffold. The changes of nasal shape, plastic effect, complications and satisfaction were compared between the two groups. Results The distance between the alar base and the midline of the face, the longitudinal diameter of the nostril and the transverse diameter of the nostril in the observation group were lower than those in the control group, and the height of the nasal sill was higher than that in the control group (P <0.05). The nasal tip protrusion in the observation group was higher than that in the control group (P <0.05). There was no statistically significant difference in surgical success rate and incision healing time between the two groups (P >0.05). The incidence of swelling and decrease of nasal tip protrusion at half a year and 1 year after operation in the observation group was lower than that in the control group, but the difference was not statistically significant (P >0.05). The satisfaction score of the observation group was (91.49±2.13)scores, which was higher than (86.01±3.21) scores of the control group (P <0.05). Conclusion The application of autologous costal cartilage scaffold in comprehensive rhinoplasty has a good cosmetic effect, which can improve the nasal shape, with high patient satisfaction, stable long-term effect and low risk of complications.