What can be done to my make nostrils smaller and symmetrical, and my tip more narrow and refined? (Photo)

You would benefit from a tip rhinoplasty. The dorsum appears very straight and the nasal columella angle is good. The medial feet of the crura are widely separated and they can be pulled together to widen the nostrils. You will need the septal cartilage resected. You will need an open rhinoplasty that will take 2 hours to perform and will cost $7,000.

Best Wishes,

Gary Horndeski, M.D.

Most of the points you raised; bulbous tip correction, narrower tip etc are achievable with surgery. Nostril asymmetry is extremely difficult to fully correct; if you have asymmetry, this is highly likely to remain after surgery. The size of the nostrils can be altered through surgery, but it is likely that they will remain the same shape.

In many people, nostril asymmetry may be due to a deviation of the nasal septum at its base. Septoplasty for correction of nostril asymmetry, along with tip narrowing, is routinely performed. If you want your nasal tip lowered, that, in my opinion, is a difficult undertaking that would require multiple cartilage grafts. Overall, you have a pleasing nasal appearance. Would you consider a chin implant? I believe that improving your balance between your chin and nose would lead to a pleasing facial appearance. I hope this helps, and thanks so much for this question. Sincerely, Dr. Joseph