Off-center nose / crooked philtrum - how can it be fixed? Do I require a septo/rhinoplasty? (photos)

You definitely need a rhinoplasty/septoplasty. The septum is deviated as well as the nose. I recommend an open approach. The procedure will take 2 hours to perform.

Best Wishes,

Gary Horndeski, M.D.

Hello, hope you are well. Great photos and questions. Your septum can only be properly assessed by examining the inside of the nose, but you have a significant external nasal deviation that almost certainly indicates the septum is twisted as well. To straighten the nose would require a septorhinoplasty, and you could expect a tremendous improvement in symmetry.
Best,Dr. Tower

It appears that the lower edge of your septum is deforming that area. The lower edge of the septum needs to be shortened and that should help