Can asymmetrical cartilage on my nose domes be fixed? (photos)

At least from these photos, the asymmetry is very small, (when measured with a ruler, even if it means a lot to you), and it's probably not worth going through an operation to try to fix it. If we miss by a little bit, then you'd end up with a different asymmetry, probably about the same small severity as your original asymmetry, and that'd be a shame. 
But if there are other things to change about your nose that we can't see on these photos -- like, could the tip be elevated, or brought closer to your face, or is there a bump to address, then it would make it worth it go in for surgery, and the best possible attempt at correcting the tip asymmetry could be done at the same time.
Hope I explained that okay.
Remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, requiring skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.
Your nose is also a perfect example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?

It will important to examine the nose both on the inside and outside to determine the thickness of the cartilage and soft tissue/skin and to develop a plan.. there are tradeoffs for surgery and it is important that the functional aspect (breathing) of the nose remains ..

Hello Ann,Great question. Thank you for your pictures. Based on your images, you can benefit from a rhinoplasty procedure. However, an in person examination will provide you with a precise evaluation. Please visit a board certified plastic surgeon for a detailed surgical plan to achieve your desired results.

hello thank you for your question and provided information as well... based in your question and the picture you showed you are a good candidate for rhinoplasty , in your case with technique open and elevate the tip.

Hello,
Thank you for your question. An in-person consultation is essential to determine the certatin reasons of your deformity. Rhinoplasty is one of the most challenging procedures in plastic surgery, and tip plasty is its most difficult aspect. The lower lateral cartilage is (LLC) is the primary structure that is responsible for the shape and function of the ala. I have developed a Novel Technique which is called as Superior-Based Transposition Flap to reshape, relocalize and reinforce the LLC as a support material for both internal and external valves with aesthetic corrections, leaving the scroll area untouched. I use suturing techniques to achieve a narrower, refined and aesthetically pleasing tip. 

Comparing to the open rhinoplasty Closed and Atraumatic technique in Rhinoplasty minimizes swelling and bruises; maximizes healing, prevents tissue damage and eliminates a scar on the columella. To find out more please click on the attached link.

Best Regards

Hello and thank you for your question. Your nasal tip asymmetry is due to asymmetry of your lower lateral cartilage.  Based on your photographs, you may benefit from a tip refining rhinoplasty which can be performed by trimming, suturing, and reshaping the cartilage in your lower nose. This can be designed to improve the symmetry of your nose.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon.

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

You don’t mention if you have had a previous rhinoplasty because it looks like it.  An asymmetric nasaltip can be improved by working in the tip cartilage.  You could have this done best with the open rhinoplasty technique, but getting it corrected can be s bit if a challlenge.

Thanks for your inquiry. Yes, rhinoplasty surgery can modify and improve irregularities and asymmetries involving the nasal tip. There are many different methods to accomplish these changes so I recommend you consult in person with an experienced rhinoplasty surgeon in your area. 

Rhinoplasty requires exceptional skill on behalf of the surgeon and great communication with the patient about realistic goals and expectations.
Common cosmetic concerns include a dorsal hump, wide nose, sunken nose, irregularities, and asymmetries. Functional concerns include difficulty breathing through the nose, which can and should be addressed at the same time as your rhinoplasty.
Make sure to seek out the care of a board certified surgeon with extensive experience in rhinoplasty. Find someone you connect with, who will listen to your concerns and provide you with a framework for what is possible.
In your situation, you might benefit from tip defining procedures using either cartilage grafting or suturing techniques that would harmonize your nose and create a more natural, elegant look. Additionally, to make the nostrils more symmetrical, you can also consider an alar base reduction.

Gary Linkov, MD
Rhinoplasty Specialist
Manhattan

From your photos it appears that you have asymmetry of the lower lateral (tip) cartilages and curvature of the nasal septum. These are problems that can be significantly improved with rhinoplasty. Please be aware that a thorough internal and external nasal exam may reveal other issues that would need to be address during the procedure.