I would keep in close contact with good communication between you and your surgeon. The general consensus is that rhinoplasty surgery is challenging. In general, cartilage is cartilage. The properties differ only modestly depending upon the donor site. The reason that rib cartilage may be sought is that plenty of this cartilage is available. Rib cartilage is often used when other donor sites have been exhausted or when large amounts of cartilage are needed. Additionally, rib cartilage is thick and robust. However, there is pain and scarring associated with harvest of rib cartilage.

I generally choose cartilage from the conchal bowl of the ear when the septal cartilage has been previously harvested. However, the conchal cartilage is often curved, and is not as desirable when long, straight, stiff cartilage is needed. This conchal cartilage is ideal for an alar batten graft to bolster the valve of the nostril open.

Give the repair time. I hope it will resolve without further intervention

It takes several months for full healing. It your nostril still collapses then you may not have adequate internal cartilage support. Your rhinoplasty surgeon can check this out and advise you on possible options if appropriate.

First, I would point out that you are still early in your rhinoplasty recovery experience and these findings will change further over the coming months.These are excellent questions and what you are describing sounds like narrowing of the middle vault and internal nasal collapse with respiration. You would need a proper examination of course, but from what you have described a spreader graft or upper lateral batten graft may be helpful, at least on the side that is "caving in" would be a likely option. Septal cartilage is typically the preferred graft as it is from this area and does not require additional incisions. There would be no reason to suspect your septum is "gone" unless you have had prior surgery or other trauma to septum or nasal lining. An examination would be helpful in this regard.

Spreader grafts can be done on one side or both depending upon the finding and appearance of your nose and any of the listed graft sources are reasonable choices with each having certain advantages and disadvantages. One that you did not list however is banked rib cartilage which is safe and effective and has been shown in multiple studies to has excellent performance for this application and eliminates the side effects associated with harvesting your own rib. This should be a point of discussion with the surgeon you choose.

Perfect nostril symmetry is a goal of rhinoplasty surgery but would not be something one could expect with any certainty. Most of us have small differences in the size and shape our nostrils anyway but if they are grossly asymmetric, it would be important to discuss this with your surgeon if you have not done so already. Best wishes for continued improvement in your recovery.

- Sorry to hear about your difficulty with breathing while exercising.

-at 2 months post op, you certainly can wait to see what changes as the swelling and healing proceed.

-Rib is the most recovery time and risk but the strongest, while ear cartilage is easy to harvest with little risk.

-you can likely become more confident in your choices with a second opinion consultation after 6-9 months when the healing is more mature.

I hope it gets better and that these ideas help you

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All 3 cartilage sources work, but septal is usually firmer than ear. And ear is easier donor site with less morbidity than rib. My preference is septal, ear then rib. But all 3 work and in revision cases septal is usually unavailable or inadequate. Hope this helps!

Yes you have alar collapse due to a weakened lateral crus of the lower lateral cartilage., The physics behind this is that as the airflow speed increases into the nose it lowers the actual air pressure ( Bernoulli effect ). The relative increase in air pressure outside the nose causes it to collapse on inspiration. The proper way to correct this is with a cartilage graft batten from the ear ( conchal bowl) to add stability to the alar rim. . Rib and septal cartilage are too thick and easily seen. You should only do the involved side. If done correctly it will not be noticeable. I do this with local anesthesia in the office in 20 minutes

You ask a lot of complex questions..Your surgeon should have reviewed all of the above....You have to have a competent surgeon that performs a lot of rhinoplasties examine your nose and give you the necessary answers and alternatives that are appropriate for you clinical situation

Sounds like you do need spreader and/or strut and alar rim grafts, but it is difficult to tell without examining you.

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It is important to consult with your doctor regarding the best option for the cartilage graft. A proper evaluation needs to be done to determine the best surgery plan for your case. Good luck