Hello and thank you for your question! Unfortunately even though non-surgical nosejobs are popular, they are ALMOST ALWAYS done on patients who are poor candidates for it, and who would have much better results with a proper surgical rhinoplasty. If your issue is breathing difficulties from prior nasal fractures, your issues are due to obstruction of your internal nasal airways- due to at least one of the following two things: 1) collapse of your internal nasal valve(s) or 2) narrowed/blocked airway from a deviated septum. For internal nasal valve collapse, basically your structural framework of your nose (the cartilage in the middle 1/3 of your nose) has likely been collapsed/pressed in too much and narrowed your airway for one or both nostrils- you can test for this by putting your finger on your cheek just next to your nose and pulling the skin to the side (away from your nose) to see if this improves your breathing. For a deviated septum, the issue is somewhat similar, since the cartilage/bone which normally is vertical in the middle of your nose can be shifted during injuries (or just naturally) to narrow one side or the other. Both these issues can exist at the same time. These functional issues are only able to be addressed with surgery- fillers simply do not have the structural strength necessary to open up a collapsed internal nasal valve (they're too soft and pliable to hold and maintain the airway open), in addition to the significantly increased risk of blindness if they're injected in this region. Also fillers would not have any effect in treating a deviated septum.
Also, if your issues are cosmetic in nature (instead of functional)- they would similarly only be able to be properly addressed with surgery- to precisely adjust and reposition the nasal bones, and reconstruct/reshape the underlying cartilage structural framework of your nose.
Many surgeons overlook key techniques that can otherwise soften the appearance of underlying structures, significantly improving both the function and appearance of the nose, ultimately resulting in beautiful and natural appearing results (that also help you breathe better). These specialized maneuvers require a high level of expertise and experience, which most surgeons simply do not have. Given your history, an open septorhinoplasty would be the best and only approach to precisely address your functional issues, as well as perform any reshaping/refinement necessary to the tip and nasal bridge so you can both restore overall balance to your face and improve your breathing.
In addition to reshaping your nose aesthetically, your septal cartilage (or an alternative graft material) would be used to create structural grafts, reinforcing key areas like the internal nasal valve (propping it open), and straightening the septum/removing any significantly distorted portions). These steps are crucial to not only improve your breathing, but to maintain long-term symmetry and prevent future distortions.
Rhinoplasty is one of the most technically demanding procedures in all of plastic surgery—millimeters make all the difference. If a surgeon is only performing one or two rhinoplasties per month, they simply do not have the level of experience necessary to achieve the best possible result. Your nose defines your entire face—this is NOT a surgery to leave in the hands of just anyone.
I have had extensive training in complex rhinoplasty, working under one of the highest-volume rhinoplasty surgeons in the world (who performs 1,000+ nose surgeries per year). If you’re serious about getting the best possible result, I’d be happy to see you for a consultation (Virtual or In-Person) where we can discuss your goals, perform a detailed examination, and create a customized plan for your ideal nose.
I look forward to helping you achieve the refined, balanced nose you deserve!
Dr. Donald Groves
Aesthetic Plastic Surgeon
