The OP is talking about sitting crooked on purpose to avoid circulation problems, etc. That's not a good plan.

But you're right about the asymmetry. With a new saddle I generally start with it straight and then ride to town or something (maybe 10 miles) and watch where my knees end up once I have the feel for that particular saddle shape. Generally I end up rotating the saddle just a teeny bit.

One thing you do not want to do is adjust your saddle to accommodate an asymmetrical form. Better to fix the form first and then worry about fine tuning the saddle.

It's the same way with nose up or down. Some saddles work best level across the top, but different body shapes and/or riding styles dictate a little tilt one way or the other. The Adamo Road saddles I use are supposed to be installed at first with the rails level which leaves the top tilting down quite a bit. It's just the way that saddle is shaped.