If you had a nose you were unhappy with, and you got to pick any of the top surgeons in the world, would you ever have a rhinoplasty?
Yes
If so, would you ever agree to have a primary rhinoplasty that included any type of grafts (ear, rib, etc)?
Yes
One famous graft-happy rhinoplasty specialist, Dean Toriumi, is well-known for the "structured" rhinoplasty and likely uses grafts with every primary surgery. Our FPRS guy at Iowa trained with him and was a strong believer in his methods.