Is a filler able to correct my bifid nose tip? (Photos)

Question

Somehow in the last few years the dent in my nasal tip has become more defined and bothers me. I'm scared to have surgery performed and am wondering if fillers like juvederm can be used successfully to correct the issue.

Alexander Rivkin, MD · Answer

Hi and thanks for your question. You are right to avoid the pain, recovery time and expense of surgery for a small issue such as this. A hyaluronic filler like Voluma can definitely be used to correct the bifid appearance of your nasal tip, as part of a Non Surgical Rhinoplasty procedure. The filler has to be injected carefully and a minimal amount should be used - enough to make the tip smooth, but not so much that it makes the tip bigger. A bit of filler should then be used to smooth the transition between your tip and your bridge. Voluma is a better choice than Juvederm because it lasts longer (1.5 to 2 years) and has more stiffness, making it better able to create the well defined contours we need to create when we are optimizing the nose. The procedure itself is easy, quick and essentially painless. When the Voluma gets absorbed, you then have the option of a permanent filler like Bellafill, which will accomplish the same effect. If you choose to continue with Voluma you can. Filler injection will definitely not widen your tip over time. Hope that helps!

Eric M. Joseph, MD · Answer

You appear to have thin nasal skin, and this is why you can see bifidity of your nasal tip since there is a natural gap in between everyone's tip cartilages. Filling this area may be considered, depending on your examination. Thank you. Dr Joseph

Luis A. Cenedese, MD, FACS · Answer

The bifid tip can be at least partially corrected with fillers.  Sensing that you are apprehensive about the procedure you can start with a temporary filler to see if the results meet your expectations.Minor defects of the bridge (dorsum), central nose and tip of the nose can be very precisely and quickly corrected with fillers.  Improved definition of the tip, and straightening of the dorsum may be achieved. This may also result in straighter, thinner appearing nose. Reduction of a prominent dorsum or tip requires surgery.
Various fillers are available Radiesse, Bellafill, autologous fat, Voluma and Lyft are options.  Depending on your expectations for longevity and budget (pricing between $500 and $1900) a product can be chosen to best fit your needs.
There are no fillers that have been tested in this area by the FDA and therefor are considered "off label use". Silicone or Silicon may result in unpredictable future complications-not recommended.
Please consult in person with an experienced Board Certified Plastic Surgeon prior to making treatment decisions.

Hardik Doshi, MD, FACS · Answer

Suzclem,
Thank you for the pictures. Your pictures demonstrate that you have strong and well defined tip cartilages (lower lateral cartilages) resulting in the cleft seen. The nasal skin shrink wraps around he natural cartilage in this area resulting in the clefting you are observing. Using filler (e.g. Juvederm) to cover the cleft can be used, but I would advise taking a step-wise process in cautiously filling in the area to prevent over injecting and resulting in a more bulbous / elongated tip. I strongly recommend visiting a trusted rhinosurgeon who can thoroughly examine your nose and give you the pro's and con's of both an actual vs "liquid" rhinoplasty. I wish you all the best!

Anthony J. Wilson, MD · Answer

I do believe you are a good candidate for nasal filler. I would caution however to completely efface the bifid tip your nose may appear larger. I always start with less and bring patients back in two weeks for a second treatment to perfect the nose. This helps avoid excess filling in my opinion.

David L. Cangello, MD, FACS · Answer

Hello and thank you for your question. It is an excellent one. The answer is that yes, fillers could make the tip look more unified. However in my opinion that is definitely not the best solution for you. I inject a lot of noses in addition to performing rhinoplasty surgery. And over time the nose can tend to look bigger and wider if injections are continued. If you are looking for a permanent solution, which I assume you are, you could have an excellent result from a tip rhinoplasy and never have to think about having injections every few months. I would highly recommend you look into surgery. The risks are very low with this sort of procedure. Hope this helps!

William B. Rosenblatt, MD · Answer

Fillers can be used, but over time they will have to be redone and may cause problems on their own. A well done tip plasty will give you a permanent fix that will last forever. Over the years, the cost of filler will be more than a tip plasty done once.

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