Background: In this study, we aimed to evaluate the long-term results of suture and graft techniques used to increase tip projection and rotation in Open Technique Septorhinoplasty. Methods: In this study, the data of 89 patients who underwent Open Technique Septorhinoplasty were analysed retrospectively. The patients were divided into groups 1,2,3,4 and 5 according to the suture and graft techniques used. Preoperative and postoperative photographs of all patients included in the study at the 1st, 3rd, 6th, 12th, 36th and 60th months were analyzed. To measure and compare these techniques, tip projection and rotation losses were measured on all photographs using a computer program called Imagej. Results: A statistically significant increase was found between the preoperative mean Nasolabial Angle (NLA), Type Angle (TA), Byrd–Hobar Method (BHM) and Nasofacial Angle (NFsA) measurement values and the measurement values at 36th months postoperatively in Groups 1 and 4 (p < 0.05). In Group 2, a statistically significant increase was found between preoperative mean NLA, TA and BHM measurement values and postoperative 36th month measurement values (p < 0.05). In group 1 only, there was a statistically significant difference between the preoperative mean TA, BHM, Simons Method (SM), Goode Method (GM) and Powell-Modified Baum Method (PMBM) measurement values and the postoperative measurement values at 60th months (p < 0.05). Conclusions: Our results showed that suture techniques were more effective on projection and rotation than graft techniques in the long term.