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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
rhinoplasty
 
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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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"Dr. Denenberg took time to hear and
respond to all of my concerns and requests. "
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All views of this rhinoplasty patient:
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current: Right oblique
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Go here to learn how to send your photos to Dr. Denenberg,
or to arrange a personal consultation.


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: Cost Approximation for Uneven Columella?
On the left (my right) you can see that the one side of my columella hangs approximately 3 millimeters lower than the other. I would like to even out my columella (raise the lower side to the higher). How much would this cost and how long I would need to wear bandages on my nose? Also, to even the columella out, would I need to cut off part of the columella or push the lower side higher? Explaining how one would go about this procedure would be very helpful! Thank you so much!
(Questioner submitted photos)

Dr. Denenberg's answer: Leave your columella alone
What you are asking for cannot be done with rhinoplasty. An attempt at a tiny correction of an isolated area of the nose like that would certainly create some new, more bothersome, problem elsewhere, or fundamentally change the size/shape/position of your tip.  All of these cartilages are connected to each other. 

Rhinoplasty isn't perfect enough, predictable enough, to make the kind of change that you are seeking.  I know, it'd be nice, but we just don't have it yet!

Link to this question on RealSelf.com