Filler Injections for Uneven Nostrils? (photo)

I use short-term fillers on occasion for the bridge with some success but not for the nostril margin (alar margin). To improve the asymmetry a cartilage graft is what you need. This could be a minor procedure performed with minimal internal incisions and no/minimal anesthesia.

In recent years application of fillers to address irregularities following an unsuccessful rhinoplasty has become more papular despite some potential for very rare but catastrophic complications such as blindness or loss of nasal tissue.  The most common areas amendable to such touch ups are nasal sidewall, bridge or the tip.  Asymmetries of the nostrils are best treated surgically and often with application of cartilage grafts.Based on the photographs shown above the asymmetry of your nostrils seem to be minimal, and if I am not mistaking on missing a major asymmetry not easily noticeable on this picture then I would reconsider the desire for further treatment, as it is almost impossible to achieve perfect symmetry from rhinoplasty.

I can appreciate the uneven nostril shape you have though it is very subtle.  The best option would be to talk to your rhinoplasty surgeon about correcting this or talking to another surgeon about revision surgery.  Injections are used to raise a hump, create the illusion of narrowing of a tip, or creating tip raise, or helping with dorsal irregularity.  Also, injections are temporary and have to be repeated annually. 

Fillers can be an option to correct asymmetry non-surgically.  You would want to set up a consultation because without seeing you in person it is difficult to tell.

I think that hyaluronic acid fillers are very useful in revision rhinoplasty as a temporary correction or to correct a low dorsum as seen in Asian patients.  Hyaluronic acid filler can be used to correct slight asymmetries or after primary rhinoplasties that need to wait for at least a year before considering other surgery.   Use of fillers allows for normal wound healing and restoration of a reasonable appearance until definitive nasal surgery can be done, 1 – 1.5 years after previous nasal surgery.

Filler injections in the lower third of the nose, especially after scarring has taken place can be tricky. I would avoid anything permanent. In fact, your surgeon may be able to inject saline or local anesthesia in the area to "simulate" what a filler may accomplish. In the end, minor revision surgery may be the best option.