What is causing these indents underneath my nostrils & is there a way to reduce their appearance? (Photos)

Thank you for your question, it’s a great one, and one that many patients ask.

The indents you're noticing beneath your nostrils, especially when smiling or talking, are often related to the natural anatomy of the nasolabial region. These can be caused or exaggerated by a combination of muscle movement (particularly the levator labii superioris muscle), fat distribution, and underlying skin elasticity. In some individuals, the natural contours of the face or volume loss over time can make these indents more visible during facial expressions.

There are several ways to help soften or reduce their appearance, depending on your goals and anatomy:

Dermal fillers (such as hyaluronic acid-based products) can help add volume and smooth the area around the nasolabial folds and upper lip base.

Botulinum toxin (e.g., Botox) may be used in small amounts to relax the overactive muscles contributing to the creasing, though careful technique is essential.

Microneedling, laser resurfacing, or radiofrequency treatments may improve the skin texture and firmness around the area.

In some cases, surgical intervention (e.g., fat grafting or structural support procedures) may be considered, particularly if the indentations are deeply set or persistent.

A personalized in-person or virtual consultation with a board-certified dermatologist or facial plastic surgeon is the best way to assess your facial anatomy and determine the most effective treatment.

You are able to see these indentations in your nose more clearly than in other people's noses because you appear to have very thin nasal skin. 50s indentations are causing excessive nostrils show or possibly nostril asymmetry, depending on your examination, they may be permanently filled with microdroplet Silikon-1000. If everything else is fine with your nasal appearance, I would not recommend surgery for this. Thank you for your question. Sincerely, Dr Joseph

This may be from a loss of fat in the area either from aging or weight loss. I encourage you to meet with a board certified plastic surgeon near you for an evaluation to discuss options. Filler may be an option, or potentially fat grafting to reduce the prominence.

Have they always been there or did they occur after a procedure? You could potentially use filler to correct but it may make the situation worse. In this situation an in person evaluation with a cosmetic dermatologist or plastic surgeon would be very helpful to assess the underlying anatomy.