Nasal defects are common in clinic. However, how to effectively reconstruct the normal anatomical structure and restore the aesthetics of the nose has always been challenges in reconstructive nasal surgery. The classical nasal reconstruction principle based on nasal aesthetic subunits provides important guidance for surgeons. Nevertheless, to date, with the fast development of the reconstructive nasal surgery and the higher requirements for aesthetics and function from patients, whether the nasal aesthetic subunit principle remain applicable? Are there any supplements and modification for this principle in the past few decades? How do we apply this aesthetic subunit principle in intranasal lining reconstruction? To address these issues, the current review focuses on the anatomical basis of nasal subunits, the development and application of aesthetic subunit principles in reconstructive nasal surgery of recent decades, which will provide guidance for the future nasal reconstructive surgery.