Objective To explore the effect of regional graded compression refined nursing guided by subunit reconstruction principle on nasal tip stability after costal cartilage rhinoplasty. Methods A total of 90 patients who underwent costal cartilage rhinoplasty in our hospital from June 2022 to August 2024 were selected. According to the random number table method, they were divided into the control group and the observation group, with 45 patients in each group. The control group received conventional nursing, and the observation group received regional graded compression refined nursing guided by subunit reconstruction principle on the basis of conventional nursing. The nasal tip stability indicators, nasal tip aesthetic symmetry and satisfaction were compared between the two groups. Results At 1 and 6 months after surgery, the nasal tip fixed-point deviation and alar base angle in the observation group were lower than those in the control group (P<0.05). There were no statistically significant differences in nasal tip projection index and columella-labial angle between the two groups at 1 month after surgery (P>0.05). At 6 months after surgery, the nasal tip projection index and columella-labial angle in the observation group were better than those in the control group (P<0.05). At 1 and 6 months after surgery, the expert score and NTSI index in the observation group were higher than those in the control group (P<0.05). At 3 months after surgery, the scores of MROE and FACE-Q in the observation group were higher than those in the control group (P<0.05). Conclusion Regional graded compression refined nursing guided by subunit reconstruction principle effectively improves the stability of nasal tip morphology, enhances aesthetic symmetry and patient satisfaction through a scientific regional compression strategy.