What has caused my nostrils to look pointed after rhinoplasty? (Photo)

Thank you for your pictures! At 4 months, its still early on in the healing process, believe it or not.  Particularly when you have had tip work.  It's not uncommon for swelling (even while minimal) can alter the shape of the nostrils, decrease the level of definition, etc.  I would discuss these concerns with your operating surgeon as they know exactly what done intraoperative and what maneuvers were performed on your tip defining cartilages.  Hang in there! 

It looks like you have started to develop alar retraction. I would really like to see a good profile photo to confirm this. Alar retraction happens when the wings of the tip cartilages (lateral crura) are displaced up (cephalic) towards the middle corner of the eye. This is caused by removal of a portion of the lateral crura (known as a cephalic trim) and/or sutures near the tip that change the orientation of the lateral crura. The loss of support from the lateral crural cartilages along the edge of the nostril allows the scar process after rhinoplasty to pull the margin of the nostril up. This can be a challenging problem to correct. I recommend you allow a full 12 months to pass before deciding on pursuing a revision rhinoplasty. 

Your preop photo is dark and blurry and hard to see.  However, right now you are still swollen and you have to give it time to heal.

Thank you for your question. Without a thorough examination it is difficult to give you specific advice on your situation, but I can give you some comfort. Be patient. It takes several months for the edema in the nose to resolve after surgery. Continue to follow-up with your surgeon and follow their post-operative regimen for your convalescence. Your situation will most likely improve.