Would dermal filler help even out asymmetrical nostrils? Should I be concerned about possible necrosis? 1 year post op (photo)

You are quite right in having concern about the use of a filler for the nostrils, especially in the nose of someone who has undergone prior surgical rhinoplasty, which leaves in its wake fibrosis and likely a change in the underlying vascular anatomy. That being said, I have personally injected the nostrils for precisely this reason using a cohesive, low viscosity HA filler with gratifying results. You must make certain however that your injector is highly experienced in performing filler injections. Remember, the training of plastic and reconstructive surgeons is in surgery, i.e. cutting and stitching. So, it might be wise to consult with an experienced, board certified cosmetic dermatologist injector. Hope this helps.

You’re probably not going to like to hear this, but most likely, your nostrils were not symmetric to begin with before surgery. However, if symmetry is what you desire most, a filler, such as hyaluronic acid may be used to create more symmetry. I hope this helps and good luck from New York City Plastic Surgery.