Rhinoplasty or Fillers for Nose Tip Indentation?

                  Your
pictures suggest a separation of the cartilage in your lower nose. These
cartilage segments are known as the lower lateral cartilages and when they’re
separated there may be several consequences. In your case, they explain the
increased width of your nose, the central indentation and asymmetry.

                  Although
this deformity can be disguised with fillers, this solution is only temporary.
For this reason, we generally recommend surgical correction. This can be
accomplished with open rhinoplasty with direct visualization of the cartilage
abnormalities.

                  This
procedure narrows the nasal tip and removes the indentation at the nasal tip.
It also has the potential to correct nasal tip asymmetry.

                  When
this type of problem occurs, it’s important to consult a board certified
plastic surgeon before proceeding with surgery. It’s important to understand
the risk, benefits, alternatives and possible complications of each treatment
approach. 

The tip of your nose is known as “bifid” tip. While injectable fillers are wonderful for correcting assymmetries or defects in the dorsum (bridge) of the nose, using an injectable filler in the tip is a little trickier. Because of this, if you are commited to trying an injectable filler rather than surgical correction in this location, my advice would be to try a temporary or even reversible filler such as hyalauronic acid (example: Restylane or Juvederm).  First, I'd advise you to be sure that you can achieve your desired goals before considering a longer lasting type of filler (such as Radiesse or even Artifill). Of course, surgical correction of the nasal tip would provide a long-lasting and often more precise solution for you.