Seeking Second Opinion – Tip Blanching and Stiffness 14 Months Post-Op. What is the best way to correct this? (Photos)

I'm reaching out for a second opinion on my nose following open rhinoplasty 14 months ago. While I am generally pleased with the overall shape, I’ve been struggling with a few ongoing issues that are impacting how I feel about the outcome: Blanching and stiffness at the tip – The tip of my nose feels very firm and immobile. I wasn’t aware that a graft would be used in my procedure, and I’m finding it difficult to adjust to how solid the structure now feels. When I move my mouth or smile, the tip remains rigid, and the skin stretches tightly over it, causing noticeable blanching. This is particularly visible when smiling, and the underlying cartilage becomes quite prominent. Asymmetry – The right side of my nose appears sharper and more defined than the left, adding to the feeling of imbalance. My surgeon's view was that blanching like this can occur in patients with thin skin, where the skin effectively shrink-wraps around the cartilage framework. He advised that it’s not dangerous and unlikely to worsen over time. He mentioned several possible approaches, including: Doing nothing, as it may not become more noticeable. Subcision needling, to release the skin from the cartilage and potentially soften the structure (not widely used in this context, but considered low risk). Nanofat or microfat injections, to cushion the area and improve skin quality, particularly as my skin has also been affected by past Roaccutane treatment. Further surgery, involving a fascia