Assymetric nose. Tip is slightly protruding on one side, creating uneven profiles. Will a graft be needed? (Photos)

Hello! Thank you for your question.
As far as I can see from your photos your case likely involves both cosmetic and functional components. A cartilage graft (often spreader grafts) is commonly used to correct internal valve collapse and provide long-term structural support. This helps improve breathing and prevent future deformity. Surgery may be more complex and slightly costlier, but it can address both appearance and function effectively.
It would be better face to face consultation.
Best Regards!

Here a basic list of problems and challenges to face in your rhinoplasty:
-greatly over projected tip, needs invasive deprojecting maneuver with tutoring to secure it and prevent re-projection due to skin factors
-beware, you have a quite large hump, however it is not noticeable because the long tip and alae are masking it, will be present intraoperatively, has to be removed, the roof closed with osteotomies and spreader grafts applied to prevent inverted V deformity
-tip is crooked due to the presence of unilateral inversion/concavity of the lateral crura at the alar cartilages; one alar cartilave is convex (normal) and other concave (abnormal), this makes the tip lean to one side; need close to total replacement by newly made grafting to achiev a perfect tip tripod and the best symmetry possible
-asymmetrical alar base reduction is probably necessary, firstly because the deprojection of the tip will make the nostrils flare out due to basic tension principle, secondly to better stabilize and align the tip
-there is a specific type of dorsum, it is rhomboid, has its own particular technique of removal, not the standard one

With that said, you need a complex procedure that is routinary in the hands of a talented and experienced structure rhinoplasty surgeon, stay far from minimally invassive and appealing proposals of basic techniques, your case is a difficult one... but not for you... just choose properly the hands.

Based on your photos, you appear to have relatively thin nasal skin, with an s-shaped nasal appearance, and an overprojected nasal profile appearance. Goals of surgery may be to achieve a narrower, straighter nasal appearance, and a less projected nasal profile appearance, and to achieve a less distracting, and more feminine nose. I hope this helps!

You would benefit from a rhinoplasty and septoplasty. At the time of the septoplasty, some of the septum is removed and used as cartilage graft, if needed. This takes 2 hours to perform under general anesthesia and cost $8,000.

Best Wishes,

Gary Horndeski, M.D.

Your nasal deformity is quite common but I would not say that repair is necessarily simple. You would need both functional and cosmetic approaches to the nose. The cost is probably going to be surgeon specific. Most surgeons have a range of fees for first time rhinoplasty and different fees for revision rhinoplasty. You may have insurance cover some of your facility and anesthesia fees.