Nostrils look significantly uneven. Can I avoid a 3rd revision rhinoplasty? (Photos)

Hello! Thank you for your question.
As far as I can see from your photos full equality can never be achieved due to facial asymmetry. After consulting with your surgeon on the subject, it would be correct to talk for revision rhinoplasty after your 1st year has expired.
Best Regards!

It is almost impossible to achieve nostril symmetry. Any attempts can lead to taking too much off one side and then going back to take some more from the other side. As this goes on permanent scarring with poor healing can lead to worst asymmetry than before the surgery was done.
Also, it is very important to remember that nobody will look at your nostrils from below. From the front view the nostrils don't look as asymmetric as from below. Unless the asymmetry is really obvious and disfiguring, it should be left alone.

Regards
Dr. J

Hello and thank you for your question. Based on your photographs, you may benefit from another revision rhinoplasty to help correct your nostril asymmetry. Placement of extended alar contour grafts and tensioning the tip would likely help this. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon