Bifid Nose - OR time + question about temp filler fix? (Photo)

Question

I've lost 180+lbs and swear my bifid nose is more pronounced now. 1. I have to financially prioritize removing skin. Is filler likely to temporarily improve the appearance ? If so, about how many vials might be required + would it complicate future surgical fix? 2. Is there a shorter surgery to address just the cleft that could be more easily folded into safe OR time for a skin procedure (assuming I am otherwise a low risk patient)? Or is a rhinoplasty a rhinoplasty? Thank you so much!

Gary M. Horndeski, MD · Answer

If you only want the tip corrected then a tip rhinoplasty can be done.

Best Wishes,

Gary Horndeski, M.D.

Oakley Smith, MD, FRCSC · Answer

Hi, It is better for you to consult with a facial plastic surgeon who can examine you and give you opinion based on your needs and expectations. Usually it is better to correct it surgically.

Steven M. Denenberg, MD · Answer

It is possible to improve that appearance -- see the link I provided with this answer. But: there is *not* a "shorter surgery to address just the cleft". Doing that, and just filling in the cleft, would hugely complicate a later definitive operation, and I'd advise strongly against it. Similarly, I would advise against trying to "fix" it with filler. It's likely to only partially correct the cleft, and yes it would complicate a later operation, possibly very much. You've lived with the cleft for this long -- my advice would be to live with it until you have the time/ability to have a real rhinoplasty.

And you have to be very careful in selecting a surgeon. Correcting a cleft like that requires surgical expertise that the great majority of plastic surgeons do not possess.

And you have to be very careful in selecting a surgeon. Correcting a cleft like that requires surgical expertise that the great majority of plastic surgeons do not possess.

Eric M. Joseph, MD · Answer

The reason why you can see this deep cleft in between your tip cartilages is because you have very thin nasal tip skin. We have had good success in permanently fill increases like this with microdroplet Silikon-1000. The only negative of filler, is that it can lead to a slightly wider nasal tip appearance. I hope this helps and thank you for your question. Sincerely, Dr Joseph

Guler Gamze Eren, MD · Answer

Thank You for your question!We can only see the tip of your nose from your photos. You have a thin skin so the shape of the nasal cartilages is visible. If the rest of your nose does not disturb you, tip-plasty surgery will solve the case. It can be done with local anesthesia. Nose fillers may disturb the lymph draining system before rhinoplasty, it should be melted with hyaluronidase before nose surgery. Best luck!

Zoran Potparic, MD · Answer

Surgical correction of the bifold tip is best option but some improvement may be achieved with injection of filler. You should look for a true expert in non surgical rhinoplasty since filler injection around the tip carries some serious risks. Good luck.

Anil R. Shah, MD · Answer

Hi, hope this message finds you well. Congratulations on the weight loss! For best results and longevity undergoing a rhinoplasty would be ideal. When you are ready we would love to see you for a consultation where we can design the perfect nose for your face.  We would be happy to walk you through the pros and cons of both filler and surgery.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, the best option for you is a surgical rhinoplasty. This will address all of your concerns, including giving you better and smoother contour in your tip.. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

William Portuese, MD · Answer

We do not recommend fillers placed in the nose, especially in the nasal tip since skin necrosis is a real risk. Consider a closed rhinoplasty approach to accomplish reduction of the bulbous nasal tip and filling in the bifid area with the crushed cartilage graft to camouflage that area. Regarding operating room time, the procedure takes about an hour under general anesthesia as an outpatient procedure

George Lefkovits, MD - Account Suspended · Answer

A bifid nose does not require skin removal. It is due to a separation  of the domes of the cartilages comprising the tip of the nose. It can be performed under local anesthesia if this is all that your nose requires. The term Rhinoplasty refers to plastic surgery repair of the nose and can be minimal or extensive depending on what is needed. I would not suggest using a filler because the tip would still be wide and not aesthetic. Also the result is very temporary. The procedure I described is permanent and, again can be performed under local anesthesia.

Bifid Nose - OR time + question about temp filler fix? (Photo)

Answers (10)

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