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

Thank you for sharing the photos. There is nothing unusual about your nasal features, and these can be managed appropriately with routine rhinoplasty in the hands of the right surgeon. Additionally, if a cartilage graft is needed, this is often taken from your nasal septum, and as such, there is no need for additional scars or cartilage harvest from your rib or ear.

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!

Answer from Dr. Sean Hill, Board-Certified Plastic Surgeon at Lone Star Plastic Surgery in Frisco, TX:
Thank you for your question and for sharing your photos — they provide an excellent view of your nasal asymmetry.
Yes, rhinoplasty can correct a crooked nose, and it’s one of the more common — and more complex — reasons patients seek nasal surgery. From your photos, it appears there’s a combination of bony deviation and possible septal involvement, which can impact both the appearance and potentially your breathing.
Correcting a crooked nose often involves: • Straightening the nasal bones through precise osteotomies (controlled fractures) • Septoplasty, if the internal septum is deviated (which it often is in crooked noses) • Use of cartilage grafts, such as spreader or strut grafts, to support the straightened structure and maintain long-term symmetry and breathing function
Because of the structural work required, yes, this type of rhinoplasty is generally more complex than a standard cosmetic rhinoplasty. It may involve additional surgical time, and in some cases, slightly higher cost, especially if internal functional work (like septoplasty or grafts) is needed.
At Lone Star Plastic Surgery, I specialize in both cosmetic and functional rhinoplasty, and my goal is always to restore symmetry while preserving — or improving — nasal function. Every case is highly individualized, so the best next step would be an in-person consultation where I can assess the anatomy in more detail and walk you through a custom surgical plan.
And as always, make sure your surgeon is board-certified and a member of The Rhinoplasty Society, as complex nasal asymmetry requires advanced training and experience.
Warmly,Dr. Sean HillBoard-Certified Plastic SurgeonLone Star Plastic Surgery – Frisco, TX

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.

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. This can also be designed to straighten your nose, With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Grafts, sometimes, multiple, are used frequently in rhinoplasty to help restore stucture and durability to the nose. Based off of the photos alone, it looks like the bottom 2/3s of the nose are crooked, which may be related to underlying septal deviation and irregularity of the tip cartilages. Following septoplasty to fix the deviated septum, it may be necessary to support the septum with a graft. Grafts may also be used to address valve collapse of narrowing. Prices vary by surgeon and you may be able to have your health insurance cover some of the costs. You would likely benefit from in-person consultation for a full nasal exam, best of luck!

Your rhinoplasty surgery should be fairly straightforward.
I don’t see an obvious need for a cartilage craft, but each surgeon will have their own way of doing things.
Like all people you have facial asymmetry.
This can contribute significantly to the nose looking asymmetrical.
It looks like your left mid face has more projection than the right side.
All people have facial asymmetry.
This can sometimes be seen as a nose looking asymmetrical as well.
Each anatomic area looks the way it does in context to surrounding areas.
I suggest you have a few in person consultations with plastic surgeons in your community, who seem to have a lot of experience or ideally specialize exclusively in rhinoplasty surgery.
Best,
Mats Hagstrom MD