Rhinoplasty or Fillers for Nose Tip Indentation?

The bulbousness and the appearance of a indentation or cleft in the tip (often called a bifid tip) are caused by the natural curvature of your tip cartilages and would best be corrected with rhinoplasty techniques. While fillers can potentially fill the indentation in the tip, the change would only be temporary. Many surgeons are begining to see patients who come to their practice for revision surgery because they are displeased with the results of injectable fillers. Most of the... more

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,... more

Fillers have limited use in rhinoplasty and , in general, I don't recommend them.  The crease in your tip appears to be due to a cleft between the cartilages.  A filler might help but is very user dependent and would last only a few months.  Ultimately a tip rhinoplasty is probably better and will be permanent. Wishing you the best, Tal Raine MD 

Fillers would eliminate the separation of the cartilage that creates this anatomic finding. But, fillers would be temporary and will change over the course of time. Thus, immediately after filling it would look great and would fade over time. Unification of the domes is a surgical technique that would correct this problem permanently. Best of luck!

I think if you asked a dermatologist, they would probably recommend a filler, and if you asked many, but not all, plastic surgeons, we would recommend a rhinoplasty. A few thoughts to consider: A filler such as Restylane has the advantage of being quick and easy, less cost, and little to no downtime. Its purpose is to fill in the space between the two pieces of cartilage that make up the tip of your nose, therefore hiding the natural appearance of your nose, and can last a year or more. ... more

Natastic, From the appearance of your pictures, you have had very professional photographs taken. If you are a model, I think you should reconsider your concerns. The most natural appearing noses have a small indentation between the paired lower lateral or tip cartilages. The indentation corresponds to where the cartilages come together at the midline. Although in some cases the dip appears very dramatic, a complete flattening would not be recommended - from an aesthetic point of view.... more

The tip of the nose that you demonstrate in you photo shows very nice anatomy. The cartileges are paired and in your case, there is a separation between the left and right side, and the skin dips into that little depression. Rhinoplasty will correct the problem permanently. You may try various fillers but they are painful to endure, and are temporary. I would encourage you to try the filler for yourself. It is cheaper and temporary, and you have a negative attitude about surgery. If... more

Fillers work great on the nose and tend to last one to two years and sometimes even longer. I would certainly find a rhinoplasty surgeon to do your fillers, as I believe they have the most experience.  Juvederm or restylane are both very safe, and fat injection can provide a permanent fix. 

What is causing the depression on the tip of your nose is a cleft between the two lower lateral cartilages under the skin on the tip of your nose. A minor tip rhinoplasty can suture the two cartillages together and close this cleft. The tip rhinoplasty also can narrow the tip and improve the bulbousnes that you mention. A filler like Restylane or Juvederm can be used to fill this depression. The downside is that the filler will dissolve and need to be repeated. Repeated injections in this... more

Using a reversible hyaluronic acid (HA) filler such as Restylane is a good way to see how much the change pleases you. Restylane, along with Juvederm, are the two most popular fillers because they are effective, safe, and reversible in case of unsatisfactory result or complication. My preference on the nose is for Restylane because it is a bit stiffer. The result should last close to a year. I find this an effective and reasonably priced alternative to traditional rhinoplasty.... more

The depression in the tip of your nose represents the gap between the two cartilages that give the shape to your tip. It is relatively easy to change the shape of the tip cartilage with a nasal tip-plasty. Of course if changes involving the bridge of the nose are needed then a full septo-rhinoplasty must be considered. A rhinoplasty is a procedure that we routinely perform in our office surgical suite under a local anesthetic with some intravenous sedation. Since we do not ever use... more