Asymmetric collapsed nostril: Do I have a caudal problem?

Thank you for your question.  Some degree of nostril and nasal asymmetry is to be expected. There’s no such thing as a perfectly straight or symmetric nose. However, the issues that you describe and show in the photograph could likely be improved. The issue appears to at least in part be due to the medial cartilage foot plates. I would discuss with your surgeon.

Thank you very much for introducing such an interesting case.
Revision surgery needs to be taken very seriously and the diagnosis only comes after very accurate physical examination.
The treatment, of possible, is based on reproducing better symmetry between right and left cartilagineous structures. It needs to be emphasised that perfection does not exist.
I would suggest to see two or three specialists in your area, more than once, until you are completely convinced if it is worth to proceed or not.
I wish you the best of luck.
With best regards,

It could be the septum, it could be the foot plates, it could be swelling from recent work.  More details and an exam would be needed.

The base view of your nose indicates that you have asymmetrical swelling of the columella or deviation of the caudal margin of the septum. When was your surgery? If the tip collapses when taking a deep breath you could have some weakness of the tip cartilages. Is there asymmetry of the nostril rim?  Your surgeon is aware of the problem but you need to be examined if you want a second opinion.

this is a good question, but I would not be able to fully answer your question.  A full examination as well as a review of previous surgery would always be of help if you were to obtain a second opinion.  The best person to ask these questions of would be the original Surgeon.  If your left nostril collapses in with an inspiration, it would appear that a cartilage graft support would be needed.  If the septum can't be used, perhaps you would need a graft from the ear.  Hopefully your Plastic Surgeon will be able to give you proper guidance as to what to expect for the future as further healing occurs.Good luck to you.Frank Rieger  M.D.  Tampa Plastic Surgeon