How predictable are alar rim grafts? Is their longevity closer to 1, 5, or 10 years?

I am not quite sure what kind of alar deformity you have but in general, cartilage graft is more reliable than injection techniques. It is durable and more predictable in good hands. Silicone injection is not currently used anymore. If you want injection technique anyway, I recommend you resorbable hyaluronic acid filler. Thanks.

Hello, thank you for the question and provided information. Based on them a full revision rhinoplasty procedure can improve your nose for better, balanced and natural look. Only tipplasty will not be enough  to fix the deviation, alar retractio is treated with graft material and when performed professionally the result becomes permanent.
Kind Regards,

based on my 44 years of rhinoplasty I can assure you that a alar rim grafts if properly done last forever. I would not use silicone due to permanent complications. 

In general, cartilage grafts are one of most reliable grafting material available in reconstructive surgery; using allar cartilage grafts for correction of retracted alla is the most appropriate and predictable way of correction in hands of an experienced rhinoplasty surgeon. Correction with soft tissue fillers, in particular one as unpredictable as silicone, is not reliable and may actually be very dangerous in inexperienced hands. There is no time limit on cartilage grafts; they do not loose volume and in this particular area they will retain the shape for ever. I hope this answers the question which surgeon to trust. Good luck.

 Revision rhinoplasty more difficult than a primary rhinoplasty due to the fact that there have been previous alterations to the normal anatomy, scar tissue present, and thick skin.  In our practice, alar retraction is usually treated with a composite graft harvested from the ear. If there's a collapsing of the alar rim with inspiration, then an alar rim graft can be of some benefit. Once the cartilage grafts are placed and live, they last forever. We do not recommend silicone injections in the nose

I have successfully used alar rim grafts for nostril retraction for over 30 years without problems or loss of the  cartilage. Injections of silicone into the nasal tip sounds easy but complications can be permanent.