I’ve always had a nose with a dimple / divot running through the center of it almost like a continuation of my philtrum. Although it is not a major concern per se, it contributes to my overall sense that my nose is not particularly flattering to my face and that a more defined shape would better suit my features. Surgery is inherently a risky proposition, and most of the photos I see of rhinoplasty before and after cases are of people with more extreme bumps, humps etc. I have considered filler as well (and have some filler in my cheeks and under eyes already) but have heard that fillers in this area are extremely risky. My board certified dermatologist injector does not perform this procedure and neither does my previous ENT plastic surgeon (unrelated procedure). In any case, is this the type of problem that could satisfactorily be addressed through rhinoplasty? I’m wary of perfection being the enemy of the good!
Answer: Nasal Tip Cleavage Thanks for your thoughtful question. A subtle midline indentation or cleavage in the nasal tip can indeed contribute to a feeling that the nose isn’t ideally suited to your face. While most rhinoplasty cases online highlight dramatic changes like large bumps or humps, more refined aesthetic concerns like yours can also be addressed with surgery. A well-planned rhinoplasty could help smooth the contour and enhance nasal definition, improving overall facial harmony. You’re right that filler in this area is risky due to the vascular anatomy, and not all providers offer it for that reason. Consulting with a board-certified facial plastic surgeon who has experience with subtle nasal reshaping would be the safest and most effective next step.
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Answer: Nasal Tip Cleavage Thanks for your thoughtful question. A subtle midline indentation or cleavage in the nasal tip can indeed contribute to a feeling that the nose isn’t ideally suited to your face. While most rhinoplasty cases online highlight dramatic changes like large bumps or humps, more refined aesthetic concerns like yours can also be addressed with surgery. A well-planned rhinoplasty could help smooth the contour and enhance nasal definition, improving overall facial harmony. You’re right that filler in this area is risky due to the vascular anatomy, and not all providers offer it for that reason. Consulting with a board-certified facial plastic surgeon who has experience with subtle nasal reshaping would be the safest and most effective next step.
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Answer: Rhinoplasty vs. fillers... Based on your photos, you are a great candidate for rhinoplasty. Fillers to the nasal tip can be done (usually with minimal risk if the injector knows what he/she is doing), but the result will only be temporary. Rhinoplasty can give a permanent result while refining other parts of the nose at the same time. Be sure to find a rhinoplasty expert for consultation that can do computer imaging at the same time so you can see how you might like your nose to be.
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Answer: Rhinoplasty vs. fillers... Based on your photos, you are a great candidate for rhinoplasty. Fillers to the nasal tip can be done (usually with minimal risk if the injector knows what he/she is doing), but the result will only be temporary. Rhinoplasty can give a permanent result while refining other parts of the nose at the same time. Be sure to find a rhinoplasty expert for consultation that can do computer imaging at the same time so you can see how you might like your nose to be.
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June 20, 2025
Answer: Bifid Nasal Tip Thank you for your question and providing photos! To me, it looks like you likely have something called a "bifid tip" which is essentially where the lower lateral cartilages of the nose (what gives the nasal tip its shape) diverge slightly at the midline and cause a central line or indentation. There are certainly degrees of this as well and I would say yours is on the fairly minor side of that. As far as options to address this, I think it depends on how bothersome this is to you, but you could have a fairly conservative rhinoplasty just addressing the nasal tip without making other significant changes. This often involves suturing these cartilages closer together (less of a gap) and potentially adding a graft of some sort between them so the skin does not indent as much. While filler is also an option, this is a somewhat controversial topic among rhinoplasty surgeons and you need to find someone who does this alot and most importantly, that they do it SAFELY. Personally, I don't love that option as much, but something you could possibly consider. Hope this helps and best of luck!Kyle Kimura, MD
Helpful 1 person found this helpful
June 20, 2025
Answer: Bifid Nasal Tip Thank you for your question and providing photos! To me, it looks like you likely have something called a "bifid tip" which is essentially where the lower lateral cartilages of the nose (what gives the nasal tip its shape) diverge slightly at the midline and cause a central line or indentation. There are certainly degrees of this as well and I would say yours is on the fairly minor side of that. As far as options to address this, I think it depends on how bothersome this is to you, but you could have a fairly conservative rhinoplasty just addressing the nasal tip without making other significant changes. This often involves suturing these cartilages closer together (less of a gap) and potentially adding a graft of some sort between them so the skin does not indent as much. While filler is also an option, this is a somewhat controversial topic among rhinoplasty surgeons and you need to find someone who does this alot and most importantly, that they do it SAFELY. Personally, I don't love that option as much, but something you could possibly consider. Hope this helps and best of luck!Kyle Kimura, MD
Helpful 1 person found this helpful
June 19, 2025
Answer: Rhinoplasty Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. 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
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June 19, 2025
Answer: Rhinoplasty Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. 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
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June 19, 2025
Answer: Filler to the tip of the nose Separated cartilages and thin skin are reason for this tip “deformity”. It is very likely that injection of soft tissue filler would solve the problem. Tip surgery, including placement of fascia graft are options. In person consultation with a board certified plastic surgeon, expert in rhinoplasty, is recommended. Good luck.
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June 19, 2025
Answer: Filler to the tip of the nose Separated cartilages and thin skin are reason for this tip “deformity”. It is very likely that injection of soft tissue filler would solve the problem. Tip surgery, including placement of fascia graft are options. In person consultation with a board certified plastic surgeon, expert in rhinoplasty, is recommended. Good luck.
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