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CLAIM YOUR PROFILEHi there -
This will not in essence 'worsen' with age, but the overlying skin and soft tissue will gradually thin over time, and might make the contour more apparent by feel and visually. You can always address it then should it occur. Filler is not a great long term solution. The bone on the left can be re-broken (under anaesthesia) in order to help close the gap, likely in combination with the addition of some crushed cartilage form the ear. You can also just leave it well alone!
My best,
Noah
Board Certified Facial Plastic Surgeon
Hello -
It is possible to extend the length of the nose and counter-rotate the tip (bring it down closer to the lip).
This is one of the harder goals to achieve during rhinoplasty, as it involves augmentation with cartilage (specifically extended spreader grafts), and the result largely depends on the 'elasticity' of the nose.
In your case this would almost certainly require rib cartilage from your own rib, or from a cadaver.
I hope this helps!
My best,
Noah
Board Certified Facial Plastic Surgeon
This is an unfortunate result of a 'nervous habit' for many patients. There are options to improve the contour of the depressed area.
I would suggest trying a small amount of dermal filler first, and see the degree of improvement.
If this were to help, you could repeat the treatment every 6-12 months. A more permanent option is harvesting soft tissue from behind the ear and insetting it into this area, which can potentially be done in the office. The latter would be my recommendation.
My best,
Noah
Board Certified Facial Plastic Surgeon
Hi there -
I generally favor chin implants to sliding genioplasty. Simpler, reversible, and less painful. A better question for your anatomy would be sagittal split osteotomy (lower jaw advanced forward for the purposes of better occlusion/relationship between upper and lower teeth) and a chin implant.
For adults, I prefer the latter for the same reasons I listed above.
My best,
Noah
Board Certified Facial Plastic Surgeon
Generally speaking, your profile view is nice. Rhinoplasty does not need to be overly done, drastic, or apparent to the average observer. In fact, is should not draw negative attention at all. You are certainly a candidate if you wish to improve various aspects of the nose (or even a single aspect). Generally for Middle Eastern noses I leave the tip slightly more projected than other backgrounds, and the bridge slightly higher (without leaving an actual hump) to appear true to its heritage.
Board Certified Facial Plastic Surgeon
Hello,
One view is always limiting, making it hard to fully evaluate the before/after shape of your nose. At least from the front view, the tip does appear more refined, and the aesthetic lines are more symmetric.
I would consult with your surgeon to discuss your concerns, and potentially get a second opinion in consultation with in-office standardized photographs, if you happen to have them.
Board Certified Facial Plastic Surgeon
Hi and thank-you for your question. The lips comprise the area that bruises and swells the most following filler injection. Most of the swelling/bruising will have settled at the 1 week mark. The firmness should settle as the swelling settles - gentle massage can help as well. I normally tell patients to wait 2 weeks before considering touch-ups. Given it has only been 3 days since your injection was done, smiling will feel a bit unusual. This will improve over the next week or two.
Board Certified Facial Plastic Surgeon
Voluma is my preferred filler for jaw contouring, including chin projection. HA fillers can be used to augment the chin, and improve symmetry and contour. The products can also be used to fill a deep mento-labial sulcus (groove between lower lip and chin). Generally, 1 vile is enough for the chin, cost varies depending on the product used, and geographic location.
Board Certified Facial Plastic Surgeon
Hi there, it is simply too early to tell if this is swelling or not. If the result of the filler looked favorable initially, it is likely swelling given it has only been 3 days. Swelling and bruising could last a few weeks. The filler (part or whole) could be reversed if needed, but I would wait at least a month to make that determination. Massage the area!
Board Certified Facial Plastic Surgeon
Hi,
Smart phone photos can certainly accentuate certain irregularities, but it does appear that your lips are generally over-filled, at least in my opinion. In general, if your lips were asymmetric prior to the injection, this is sometimes hard to correct with HA filler. Basically filler augments the natural shape of your lips and adds volume. Without seeing a before photo, it is a bit hard to gauge. I'd recommend that reversal enzyme is applied, particularly to the outer portions of your upper lip. This does not mean that all of the filler needs to be reversed/degraded. I would also recommend having your filler performed by a cosmetic surgeon or Dermatologist, as lips are not especially 'easy'.
Board Certified Facial Plastic Surgeon
Working with Dr. Noah Sands was one of the best decisions I’ve ever made. I initially came to him to address a deviated septum, and during our consultation, we also discussed doing a chin implant. I had always been insecure about how small my jaw was but never really thought there was anything I could do to change it. Dr. Sands listened closely, and his thoughtful approach made me feel completely comfortable moving forward. What really sold me was his philosophy: functionality first, aesthetics second. That mindset gave me so much trust in him. And even with that practical approach, he still delivered results that far exceeded my expectations. My nose not only functions better — I can actually breathe more clearly now — but it looks so natural that no one would ever know I had surgery. The chin implant made an even bigger impact on my overall appearance and confidence; it brought proportion to my face in a way that feels completely “me.” The results are subtle and natural — exactly what I hoped for. The incisions are barely noticeable, and nothing about my appearance looks “done.” Beyond his skill, Dr. Sands is warm, grounded, and incredibly easy to work with. He was always available for questions, made me feel supported throughout the process, and truly cared about the outcome. If you’re considering facial plastic surgery, I can’t recommend Dr. Sands enough. He’s the kind of doctor you can trust — both for his surgical expertise and his genuine care.
Dr. Sands is a miracle worker! I was a very complicated case as I had a bad accident which left my nose mangled internally & disproportionate on the outside, due to a bad "sew her up & get her on her way" job the hospital had done post accident. I also had an unsightly scar between my eyebrows from a laceration. I was very nervous going in as I had been so self conscious about my face for years because of all this & was losing hope that I could ever look/feel like myself again. Dr. Sands put me at ease instantly & even offered the option of Z-Plasty for my scar, which I didn't know was possible, & wouldn't have thought to address as I was initially just going to have my nose looked at. It was this level of care that made me know he'd be the best surgeon for me! I am now 3 months post op & actually look/feel like myself again! He did an absolutely INCREDIBLE job on my nose. I can breathe again, and esthetically, it is absolutely gorgeous. I have been complimented so many times! The Z-Plasty is healing amazingly as well & it's been an out of this world feeling to not have to see that scar every time I catch a glimpse of myself in the mirror. He's also been so helpful & kind during my monthly follow ups I've had with him to check in on my progress. If you are looking for a surgeon you can trust, do yourself a favor & book with Dr. Sands. I swear it'll be one of the best decisions you've ever made.
Dr. Sands is more than a highly skilled and talented plastic surgeon. He is also a great communicator. He was not only able to answer all of my questions and concerns, he made me very comfortable. I would recommend Dr. Sands without hesitation. I feel very grateful that he was my surgeon.
I am very pleased to have been able to have had the opportunity to work with Dr Sands. I’ve had problems with my breathing the majority of my life. I had a tonsillectomy done at an early age. I didn’t notice I would breathe through my mouth until a friend brought it to my attention, she told me I should look into an ENT. I went on Zocdoc and looked for a doctor that was in network with my insurance and found Dr Sands profile something about his reviews and his picture drew my attention. I had my first appointment with him and he had such a friendly smile and, he was very attentive to my concerns. He examined me and told me I had a deviated septum that was causing my issues. I also wanted to know about the rhinoplasty procedure since we had spoke about septoplasty. I’ve always had an insecurity with the bridge I had on my nose. We booked another appointment and We spoke in detail about our about the procedure. I gifted myself rhino plastic for my birthday like I always wanted. Dr Sands, took pictures of my nose profile and showed me what the changes would look like. I felt very pleased with the images and was very confident with him working on me! the day of my surgery I was a little nervous, but Dr Sands comforted me and reassured me Everything was going to be fine. He was very confident in his field of work so I wasn’t concerned that I wouldn’t like the finished product. I think I even told him “I trust you”. It didn’t take long for my bruising to go down and I starting seeing my new nose take shape. I was and still am in love with my results. I got complements not just from friends and family members but even strangers at Walmart! I finally had my dream nose not only where I can breathe correctly through but also looks great and so natural! Dr. Sands is not just a doctor,He is an artist!! thank you so much for everything you do and have done, not just in my life but in others as well. 5/5 Recommend!
Shortly after COVID re-opening, I had the privilege of being under the care of Dr. Sands, and I can't recommend him enough. From start to finish, my experience with Dr. Sands was exceptional. What sets Dr. Sands apart is his down-to-earth and caring approach. Unlike my previous experience with another doctor where I felt like just another "sale," Dr. Sands made me feel like a valued individual. He took the time to listen to my concerns, answer all my questions, and truly understand my needs. Prior to my surgery, Dr. Sands went above and beyond to ensure I was comfortable with every aspect of the procedure. He patiently explained the process, potential outcomes, and addressed any worries I had. His genuine care and attention to detail put me at ease and gave me the confidence that I was in capable hands. After the surgery, Dr. Sands continued to be attentive and supportive. He monitored my progress closely, making sure that my recovery was going smoothly. Knowing that he was there to support me during this crucial time was incredibly reassuring. I can't express enough how grateful I am for Dr. Sands' exceptional care and dedication. He's not just a skilled surgeon but a compassionate and genuine healthcare professional. If you're looking for a doctor who truly cares about your well-being and goes the extra mile to make you feel comfortable, I wholeheartedly recommend Dr. Sands. He's a true gem in the medical field, and I couldn't be happier with my experience under his care. Thank you, Dr. Sands, for your outstanding service and for making a difference in my life.
THE BEST! Dr. Sands addressed all of my issues with patience and kindness and a strong attention to detail throughout the entire surgical process. Easiest 'yes' for a gifted surgeon on a multitude of procedures.
I can't express enough gratitude to Dr. Sands for the great septorhinoplasty experience I had under his care. From the initial consultation to the final follow-up appointments, Dr. Sands has ensured both my aesthetic and functional needs were met with precision and care. Dr. Sands' wealth of knowledge and expertise in his field were apparent from our first meeting and gave me confidence in choosing him as my surgeon. My surgery itself was seamless, and the results of my septorhinoplasty have been life-changing. My breathing has notably improved (I find myself waking up with my mouth closed for the first time) and the aesthetic improvements to my nose are remarkable. My nose fits my face perfectly and looks incredibly natural - I LOVE it! I wholeheartedly recommend Dr. Sands to anyone seeking a similar procedure. His expertise and genuine care for his patients are obvious. My only regret is that I didn't do this sooner. Thank you, Dr. Sands, for changing my life for the better!
I spent my entire life with a nose I didn't like, and one day, also as a gift to myself for almost turning 40, I decided to get a rhinoplasty (also septoplasty) and made an appointment with Dr Sands, I was very anxious because I know my nose was difficult to deal with - too big for my face-crooked-and very thick skin, so I didn't want to expect much from the results, as to ready myself for not ever having the nose I want. Dr Sands was kind enough to see me a few times to answer all of my questions before I finally decided to schedule the surgery. Now, a little over 3 months since I had surgery, I simply cannot believe the results that have exceeded my expectations, even though my nose is technically a little swollen still (which I cannot see) it already looks incredible, natural, and by that I mean, my nose complements my features and I am no longer self-conscious about it, and that should be good enough reason to invest in plastic surgery. I honestly can't thank you enough Dr Sands!
There is no one else I would have trusted more to perform my rhinoplasty. Dr. Sands is a true master of his craft. Starting with my initial consult, Dr. Sands, took time to explore my goals for rhinoplasty in detail. He went above and beyond to answer all of my questions and outline an approach to produce the results I was hoping for. Scheduling was effortless and he even accommodated my schedule traveling from out of state to seek his care and expertise. The day of the surgery, Dr. Sands spent time reviewing his plan and ensure that I was calm and comfortable. He was one of the most professional physicians I have ever worked with. Following surgery, Dr. Sands was sure to check-in multiple times on how I was feeling and healing. He again accommodated my travel schedule for my after care visit and even within 5 days the results were more than I could have hoped for. Having just had my six month follow-up, I feel certain I made the right decision to choose Dr. Sands as my surgeon.
I cannot speak highly enough about Dr. Noah Sands! Dr. Sands is authentically engaging, incredibly knowledgeable and has tremendous attention to detail! What I really love about him, is that he talks to me like a normal person and not a patient. He listens intently and he remembers conversations! After my initial consultation, I knew I wanted Dr. Sands to perform my revision rhinoplasty; however, it turned out that I also needed a septoplasty! I had some difficulty breathing clearly through one of my nasal passages, but always thought it was allergy related, but Dr. Sands assessed and determined that I had a deviated septum! I not only was getting a better looking nose, but I was going to breathe better! My revision rhinoplasty was very complicated and complex as Dr. Sands needed to repair and rebuild the bad work from the first surgery! It was a big feat! The improvement to my nose is truly incredible. The results after 1-year keep getting better and better as the weeks go by! I cannot wait to see how my results continue to evolve as the healing settles. I highly recommend Dr. Sands, whether it's a rhinoplasty or a septoplasty or a combination of both! I've already referred one friend to him who needs a septoplasty and would be more than happy to refer many more! My experience working with Dr. Sands was truly wonderful.
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