Is this cartilage missing or my nose lacks fatty tissue? (photo)

Based on your photo, I can see that you have deficiency of cartilage in your left nasal tip, and your nostril margins are also High and a bit asymmetrical. Sometimes microdroplet Silikon-1000 injections can be useful for permanently adding volume to somebody's nose after previous surgery to achieve a less operated nasal appearance. I hope this helps! Sincerely, Dr Joseph

Hello and thank you for your question. Based on your photograph, you may benefit from a revision rhinoplasty. Extended alar contour graft can be placed to help correct your left nostril. 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

It is interesting you say that you can't put all the blame on the surgeon. was the crooked nose attempted to be corrected at the 1st surgery or did become worse after the 2nd surgery. I am curious to know if septal work was done as well and whether not you had cartilage grafts. It appears as though the columella remains crooked pushed off to the left side which accentuate the tip being off center. From the photographs I can not tell for sure although it looks like the cartilage on the ala rim has been over resected but without palpating this it would be very difficult to say. Have you gone back to either the 1st or 2nd surgeon to see what they would do and how they would corrected? If neither 1 can are is unwilling to then I would suggest finding someone with more experience in revision area rhinoplasty to see how the nose can not be corrected and what would be necessary.
Good luck,
Dr. Steven Schuster in Boca Raton Florida