Should I get revisionary rhinoplasty
Tip refinement can be performed in closed fashion so that you do not have any visible scars. The breathing issues can be addressed at the same time.
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Kenneth Hughes, MD
Los Angeles, CA
Rhinoplasty and septoplasty combination
It is important to examine of the internal portion of the nose to determine what is causing the breathing troubles. Turbinate hypertrophy, a deviated septum, valve collapse, allergies and chronic sinusitis can all cause breathing issues. Each one of these is treated differently by an ENT/ facial plastic surgeon.
The revision rhinoplasty procedure can address cosmetic improvement and refine the nasal tip cartilages. For many examples, please see the link below to our rhinoplasty photo Gallery
Tip cartilage orientation
As others have pointed out, you clearly have "cephalically oriented" tip cartilages. This means that the cartilage that extends from the tip and supports the area above the nostril rims is oriented vertically instead of more toward the outside corners of the eye. There are surgical techniques used to correct this. You should see a surgeon who understands this issue and knows how to correct it. Further cartilage excision in your case would probably make this worse.
Your tip is not swollen, you have vertically oriented tip cartilages. you need a revision to reorient them and shape your tip domes.