Rhinoplasty: Q&A

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My nose seems to be caving in at the tip... can this be fixed with a filler?

My nose seems to be caving in at the tip and each year seems to be getting worse. I have always had sinus problems and am wondering if I have a deviated septum? Can my nose be fixed with a filler? If I do have a deviated septum, does insurance cover rhinoplasty?

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14 Doctor Answers | Asked by Candace Wellington in Wellington, Florida

Doctor Answers (14)
Community Comments (1)

How to best fix the groove along your nasal tip...

Careful injection of filler can camoflouge the groove temporarily, but will not actually fix what is causing the problem, and it may not give you a look that you like any better (it will add volume to the center and can give the whole tip a rounder appearance). It appears from the photo that you have prominent lower lateral nasal cartilages, and the groove you see is the space between the two sides. This is best addressed surgically. Also, a deviated septum could be addressed during the... more

Yes - "caving in" and deviated septum can be repaired with rhinoplasty

“Caving in” could be due to a loss of cartilage, or secondary to weakening of the nasal ligaments resulting in drooping of the cartilages. These problems can usually be effectively repaired with various rhinoplasty techniques. As far as a deviated septum, this is usually a procedure covered by insurance, but this does not include the cosmetic rhinoplasty work.

Nasal tip depression

I can see from your photos what bothers you. A long term permanent treatment would be to have a tip rhinoplasty.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Fixing depressed area in the middle of nasal tip

As the others have mentioned, the depressed area you see is actually due to prominent nasal tip cartilages combined with thin nasal tip skin. This tip bifidity can create quite a bit of shadowing and draw attention to your nose. I wouldn't recommend a filler injection to conceal the depressed area as this would mainly result in a fuller tip. A rhinoplasty can be done to improve the appearance of your tip greatly. Your lower lateral cartilages are very convex. By giving them a... more

Be careful of fillers in the nose

The area that you seem to be describing in your picture is that there is a small cleft at the tip of your nose between the cartilages that form the tip-the lower lateral cartilages. The best correction for this would be rhinoplasty, or surgery to correct the shape of your nose. While fillers have wonderful applications, the nose is one area where caution is advised. There is likely a greater risk of skin injury with a filler at the tip of the nose in particular.... more

Can a "Butt Nose" caving in at the tip be fixed?

Regarding: "My nose seems to be caving in at the tip... can this be fixed with a filler? My nose seems to be caving in at the tip and each year seems to be getting worse. I have always had sinus problems and am wondering if I have a deviated septum? Can my nose be fixed with a filler? If I do have a deviated septum, does insurance cover rhinoplasty?" You may have chronic sinus issues (?allergies). You may have septal deviation which may or may not be associated with the sinu more

My nose seems to be caving in at the tip... can this be fixed with a filler?

The poor photo posted makes giving advise difficult. You appear to have a separating lower lateral alar cartilage medial crura. Yes filler can temporarily improve. Also there is a deviation of the septum I think. Insurance ONLY covers the septal correction the cosmetic rhinoplasty is your responsibility. Good luck from MIAMI Dr. Darryl j. Blinski

Nasal depression

As some of the other surgeons have mentioned - the depression you see is the space between your lower nasal cartilages visible through your thin nasal skin. ( I don't know if you can find an image on line - if I saw you in person I could draw you a picture). I would recommend rhinoplasty with tip work to bring the edges together. Regardless, I'd recommend you find a trusted rhinoplasty surgeon. He/she will be able to review your individual anatomy, discuss with... more

What is the best option for a bifid nasal tip?

In some people, the cartilage of the nasal tip is very prominent and combined with relatively thin skin leads to a groove. Although filler could be used to conceal the groove, aesthetically it would just make the tip look larger. The best solution for this is surgical correction. It is a relatively difficult surgery but the results can be outstanding. While it is certainly possible that you have a deviated septum and a functional anatomic problem that can be treated... more

Using filler for cleft in tip of nose

The thinning of your skin is most likely visible fof the cleft you see in the tip of your nose. It is the normal separation between the two cartilages that support the nostril and tip. A filler could be used to give you an idea of what it might look like with a longer term correction which would best be cokmpleted with cartilage. Correcting a deviated septum does not mean that the external appearance of your nose will change.A filler could be used see video

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Rhinoplasty is the best option for you

Rhinoplasty is the best option for you. You have prominent lower Alar cartilages that are clearly seen through the skin at your tip of your nose. The operation which will concentrate on this area will correct this. I would be careful of injections which might leave you with more of a defect and may only be short term in camouflaging the issue. Good Luck to you. Kimberly Henry M.D.

Nasal Tip Depression

Candace You have a combination of prominent nasal tip cartilages and relatively thin nasal tip skin. The best treatment for a nasal tip "cleft" or "bifidity" is surgery, however fillers a good second option. If you are considering this option, I would recommend only board certified plastic surgeons to administer a small amounts of hyaluronic acid filler to correct this depression. Too much filler in one area can compromise the blood flow. The... more

Juvederm for the tip of your nose.

Juvederm an be tried and this will give you a nice idea of the appearance you will have. Juvederm is simple to do and long lasting in the nasal tip (in my experience 2 years plus). You can repeat the juvederm or consider a simple tip rhinoplasty. This would involve adding cartilage or shifting the nasal tip cartilage and would be a permanent correction. Good luck.

Nasal Tip Findings

What you are noticing is what is described as "nasal tip bifidity", or in lay terms, you can visualize the space between the nasal tip cartilages. Based on the photo (and experience), your nasal tip is not caving in, but instead you are likely to have relatively thin skin in the setting of relatively large nasal tip cartilages. A filler is definitely not the treatment of choice in this circumstance. If you are unhappy with the appearance of your nose, I would suggests a... more