Would dermal filler help address tear troughs and asymmetrical nostrils? Should I consider an alarplasty? (photos)

Nostril Asymmetry
It is almost impossible to achieve nostril symmetry. Any attempts can lead to taking too much off one side and then going back to take some more from the other side. As this goes on permanent scarring with poor healing can lead to worst asymmetry than before the surgery was done.
Also, it is very important to remember that nobody will look at your nostrils from below. From the front view the nostrils don't look as asymmetric as from below. Unless the asymmetry is really obvious and disfiguring, it should be left alone.

Regards
Dr. J

Alarplasty would look great but likely still will have some asymmetry left. Correcting the asymmetry very difficult in any rhinoplasty. I don’t buy into the tear trough thing but you could try it if you wanted. I think it’s a waste of money

Filler or surgery for tear trough and wide nostrils: Filler is the usual treatment used for deep tear troughs. You appear to have wide nostrils. the solution for wide nostrils is an alar plasty.