Dane Barrett, MD

In noses with thicker skin, changes made to the nasal cartilages may not be as noticeable compared to patients with thinner skin.  Nonetheless, I'd recommend that you consider another consultation with an experienced facial plastic surgeon.  Depending on what your goals are, refining your nose should be an achievable goal.  Best of luck to you!

I would recommend talking with your rhinoplasty surgeon.  Usually, and inverted V does not improve, and may require revision to correct.  The revision can be relatively minor or more extensive given the severity of the deformity.  Best of luck to you!

I agree that seeing an ENT or facial plastic surgeon is the way to go.  Physical examination and CT imaging will help to delineate the source of your discomfort.  If you've had a rhinoplasty in the not too distant past then it may be a good idea to see your rhinoplasty surgeon as well.  What you had done in the past my be impacting the symptoms you are experiencing. 

Yes.  This can all be accomplished fairly easily along with your other concerns with a rhinoplasty.  Making adjustments to the septum are often done to shorten the nose and alter the position of the nasal tip. When you go for a consultation with a rhinoplasty surgeon, make sure to voice all of the concerns you have with your nose so that you and your doctor can have an open conversation about what can be done to achieve your goals.  Best of luck!

Yes. Retraction of the nostrils, or nasal ala, is a known complication of rhinoplasty surgery.  It is certainly possible to do that and usually the revision procedure is less invasive.  The techniques for accomplishing this vary, but it usually involves using cartilage grafting; either borrowing cartilage from your septum to place small grafts along the alar rims (rims of the nostrils) or using skin and cartilage from the ear to place inside the nose to lower the ala (nostrils).  There are various techniques surgeons have, but it should be a relatively easy fix. I'd recommend talking with your original surgeon.