Filler or nose job for uneven nasal tip? Is it possible to have a filler to even out the middle of the tip of the nose? (photo)

You could try filler first and then if you like it have a permanent collection with a rhinoplasty. 

Hello and thank you for your question. If you seek a permanent and stable fix, I would recommend a surgical rhinoplasty.  The asymmetry is due to your lower lateral cartilage.  Based on your
photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thank you for your photos. It is possible to fill in the tip of the nose between your cartilage with injectable filler if performed carefully. Aggressive or incorrect injection can cause permanent tissue damage or loss to the tip of your nose and the results will subside over time. A rhinoplasty to alter your nasal tip framework can be done as well for a permanent fix. Isotretinion will hinder your skin's ability to heal and therefore you may need to discontinue the treatment if possible for six months before proceeding with surgery. It is best to have an in-office examination to determine the most effective and safest options available to you. Hope this helps!Johnson C. Lee, MD Plastic Surgery

Rhinoplasty is a surgery to improve the shape of the nose for breathing or appearance.Non-surgical rhinoplasty is a technique where a temporary filler is injected into the nose. Even if you like the result, you'll need repeat injections to maintain the result. Any filler injection bears the risk of blocking a blood vessel causing tissue loss. If this happens in the tip of the nose, it can be catastrophic. The reconstruction is difficult and it will never look as good as your original nose. My personal belief is that a rhinoplasty surgery would be more precise and long lasting. I like to use 3D computer simulation to get on the same page as my patient regarding potential changes that are appropriate to achieve a safe and happy outcome. Safety comes first. 

  In our practice, we do not recommend nonsurgical rhinoplasty due to multiple complications that can occur from it, it is not FDA approved, and is only temporary.  A surgical rhinoplasty can accomplish straightening the nasal bones with osteotomies, straightening the midportion of the nose with spreader graft placement, and straightening the tip of the nose with a tip-plasty.  For more information and many  surgical  rhinoplasty examples, please see the link and the video below 

The simple answer is YES but may ultimately choose to do something more permanentDr Corbin

I suggest you consult with a rhinoplasty specialist, that is someone who devotes most of their practice to this work. What you see are not changes that occur with normal aging of the nose. The asymmetry of the tip is not easily corrected with fillers and the results are temporary.

My advice would be to proceed with a rhinoplasty surgery and avoid the risk of tip necrosis with filler injection.  You can take the small statistical risk of losing part of your nasal tip but if a vessel is cannulated and blocked the problems can be permanent and severely deforming.  A patient of mine just had this happen after injection out of state and fortunately recovered with hyperbaric oxygen (though not all do).   In the end it's your decision but please be aware of the risk.  There is no technique for injection that guarantees a complication free treatment.  Regards,
Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca