Would rim grafts help my triangular nostrils appear more round? Looking for permanent solutions (photos)

The notching you're experiencing is likely due to trimming of the lateral alar cartilage, followed by the closure of the incision inside the rim with a suture that may have been slightly too tight at the area known as the soft triangle. While fillers can offer some improvement, as you mentioned, their results are often temporary. A more lasting solution would likely involve placing a lateral alar rim graft or a graft in the notched area, along with potentially releasing the tighter scar tissue at that spot. The graft can be placed first to assess if it resolves the issue before considering any additional steps during the same procedure.

Dr. B.

Hi - I would strongly recommend seeing a rhinoplasty focused surgeon in consultation and identifying your goals and letting the surgeon you trust come up with the right plan to help you achieve those goals.
There are multiple maneuvers that can be done to reshape the nostrils and you may need 1 or multiple of those maneuvers that could include cartilage grafts to strengthen the soft triangle facet.