Among the many places I consulted, this was the only one that recommended adding donated dermis over silicone, and it was also the first place that told me I had asymmetry.
They said that because my face itself is slightly tilted, either to the left or right, even if I had nose surgery, the asymmetry would not be completely corrected.
The recommended surgical approach was: for the tip, autologous costal cartilage or donated costal cartilage with ear cartilage used as a cover; for the columella, autologous costal cartilage (the director's recommendation) or donated costal cartilage plus septal cartilage. For the bridge, they recommended adding donated dermis over silicone. Overall, they said donated costal cartilage or donated dermis are good materials.
The director consulted in a friendly way and told me to ask as many questions as possible, saying I had come a long way for the appointment and should tell him everything I was curious about. That part was very good.
But the disappointing part was that, since it is a one-doctor clinic, there is no separate aftercare, and for cases like a bulbous nose, scar tissue tends to last longer, so they said they would give scar injections for free.
In the end, the nose shape the director makes is not my style, so I just left after a consultation that felt pleasant.