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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
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One of the advantages of using an artificial material to build up the nose (as I did here) is its easy availability: just unwrap the package.  Many plastic surgeons like to use the patient's own cartilage to augment a nose like this.  Frequently, however, a nose that has been injured has broken and injured cartilage inside, which might make that cartilage unavailable for the task of augmenting the nose.


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current: Left oblique

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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
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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