It sounds like you have "bossae" formation, which is very common after first time rhinoplasty—especially in thin-skinned individuals or those who have had excessive cartilage removed. Revision rhinoplasty is the best treatment, but I recommend you see an expert who specializes in revision surgery. Also, discuss the use of temporalis fascia during the surgery to soften the region.
Over time with healing, your tip cartilages have become asymmetric, with the right tip becoming more defined- likely some type of partial division or narrowing of the tip was done in your original surgery. To repair, as my experience has taught me, given what appears to be your somewhat thin skin, it is not enough to simply trim the cartilages, as this will with some time likely lead to the appearance of irregular cartilage again- therefore some type of sculpting with reforming of a soft right nasal tip will be necessary.
The cartilages the form the nasal tip, the lower lateral cartilages, are often sutured during rhinoplasty to both narrow and provide more refinement to the tip. A very common suture is the dome binding suture. This suture pinches the cartilage at its most prominent point, the dome. The nasal skin continuously contracts after surgery, so it is not unusual for imperfections to become visible many years after surgery. The only way to correct tip cartilage asymmetries is revision surgery.
I think your request to remove the cartilage graft is reasonable and can be performed with a closed rhinoplasty. Cartilage grafts can become palpable and visible. They can thin the skin and become unsightly as well.
Find a board certified plastic surgeon who performs hundreds
of rhinoplasties and rhinoplasty revisions each year. Then look at the
plastic surgeon's website before and after photo galleries to get a
sense of who can deliver the results.
Kenneth Hughes, MD
Los Angeles, CA
If you have a tip graft that has shifted or is not smooth, it may show through like in your description. But, yes, if treated it would have to be done surgically.
It would help to have more than one view of your nose. Having said that a revision by a rhinoplasty specialist is your best choice. You're a very young lady; the results will last you the rest of your life.
The only definitive method of altering the cartilage of your nose is to do so with surgery. Sometimes, it is possible to help camouflage small imperfections of the nose with an injectable filler, but this is more so on the top of the nose and not the tip.