You have a very good lip repair. Your concerns are clearly visible in the photographs. You have a significant residual cleft nasal deformity which includes loss of bony projection in the left nostril/base area(alveolar cleft)of the nose. You are correct in seeking out a surgeon with significant cleft experience. Cleft nasal surgery differs significantly from rhinoplasty in people who do not have clefts. Best to seek out someone close to where you live. Most surgeons who specialize in this type of surgery are associated with university/academic centers. Realistic expectation is for significant improvement but you will still have a residual deformity. So... it is realistic to expect a big improvement. You can get greater improvement with additional revisions, but the greatest change will occur with the first surgery.
Rhinoplasty etc for the cleft lip nose in the TG patient. Having done rhinoplasty and TG surgery for more than 35 years I can tell you to select a surgeon who can show u his revision rhinoplasty photos and cleft lip rhinoplasty along with his TG results. These can both be done at the same time. Results can be be seen at various surgeons websites along with reviews.
Thank you very much for sharing your concerns with us.
The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.
In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.
With this procedure you get a delicate nose, better harmonize with your other facial features.
Dr. Emmanuel Mallol Cotes.-