Scar tissue? Cartilage? Not sure what's inside my nostril, do I need full surgery to fix it? (Photos)

Hello, hope you are well. It appears to be deviated septal cartilage partially obstructing your nostril (or at least causing the asymmetry). This can be corrected with a simple septoplasty surgery. If the deviation is isolated to this part of the nose, it can be performed as a simple office procedure. If there are other, more significant structural or cosmetic problems to be addressed, the surgery would then typically be done under general anesthesia. This question was posted in the 'Revision Rhinoplasty' category, so if you have had prior nasal surgery that may also impact the approach for fixing the problem.
Best,Dr. Tower

From the photographs presented, it looks like you either have a caudal septal deviation to your left side, or the foot plate of the lower lateral cartilage is overriding the caudal septum. This can be improved with a closed columella plasty under local anesthesia as an outpatient procedure.