Can nostril (soft triangle region) be reshaped under local anesthesia without sedation? (Photo)

 Yes, a revision rhinoplasty to reshape the solve triangle etc. can be done under local anesthesia. The details of this would be discussed once an examination is done of your nose to see it in three dimensions. Choose a very experienced revision rhinoplasty surgeon for this.

The short answer is - yes - in many cases the soft triangle and nostril rims can be improved using local anesthesia so that small cartilage grafts can be placed. In your case, a surgeon may put a softer (morselized) cartilage graft on your left side and a stiffer cartilage graft along the right nostril rim. Even then, though, it may not create as much symmetry as you have morphed in your photo. But keep in mind that everyone has nostril asymmetry to some degree - especially when looking from below. What really matters more is what the tip and nostril rims look like from the direct frontal view. Wishing you the best luck going forward.

Rhinoplasty is a surgery to improve the shape of the nose for breathing or appearance.Rhinoplasty is the most complex surgery of the face. Nostril symmetry is one of the most challenging aspects of rhinoplasty. The bridge and tip have supporting cartilage and bone to create its shape. The nostrils are very susceptible to scar contracture, pulling it in undesired directions.Reducing the size of the nostril can be potentially be performed after your formal rhinoplasty as a procedure performed under local anesthesia. Changing the shape of the nostril is a more precise procedure usually performed as a revision surgery in the operating room. I would have a discussion with your surgeon to decide if making the improvement to the nostril is worth the risk of having a problem after surgery that could affect your entire nose. Safety comes first. 

You have a deficiency of the lower lateral cartilage on the right. This can be reconstructed under local.  Since you have had 2 surgeries, I doubt there will be enough cartilage in your septum and cartilage will have to be taken from behind the ear.   Best wishes.