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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
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Views of this rhinoplasty patient:

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Two cartilages form the tip of the nose, a left tip cartilage and a right cartilage.  In the before picture, you can see the depression, or dent, between her two tip cartilages.  They are quite prominent, and decreasing their strength was an integral part of obtaining this result.

If you don't mind looking at photos taken during surgery, the first chapter of the rhinoplasty surgery tutorial gives a good introduction to the anatomy of the tip cartilages,


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"I would highly recommend traveling to Omaha to see him. "
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All views of this rhinoplasty patient:
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current: Right oblique
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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
Get that advice for your own situation by emailing your photos to Dr. Denenberg.

Questioner: Uneven nostrils after 2 rhinoplasties. What can be done?
After two rhinoplasty surgeries. my daughter's nostrils are uneven, and she is self conscious. Her nostrils were not uneven prior to rhinoplasties. To correct them, would she require a third rhinoplasty with general anesthesia? Would it be as hard a recovery? What can be done to fix them?
(Questioner submitted photos)

Dr. Denenberg's answer: Maybe, maybe, she could have a revision of only the columellar scar
In general, that view, the bottom view, is the least important view after a rhinoplasty (or before), because it's a view that people generally don't see. Achieving excellent symmetry in that view is unrealistic, and unnecessary.

Having said that, however, it seems that much of the asymmetry is caused by a bulge of scar tissue on her left side, at the location where perhaps the incision was made for an open rhinoplasty. Maybe revising that scar would help meaningfully, with no risk to the entire rest of her nose.

Link to this question on RealSelf.com