How can I augment my philtrum/Get a nicer nasolabial angle? (Photos)

Hello and thank you for your question.  Altering one component of the nose may significantly affect another area of the nose.  Although you've asked a specific question about the nasolabial angle and augmentation of the philtrum, an exam in person is ideal in this situation.  Although injectable fillers may be used, permanent/predictable changes to the nasal tip (including your nasolabial angle) are performed with a tip rhinoplasty where the nasal tip cartilage is modified for a more refined, feminine look.  The modification of your nasal cartilage can be done with trimming, stitching or grafting.  If your septum is deviated and you have breathing difficulty, a septoplasty may benefit you as well.  The next step for you is to find the right aesthetic plastic surgeon.  In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course.  Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome.
After seeking out a board-certified plastic surgeon who specializes in aesthetic plastic surgery, I think the most important component of the consultation is to establish a good connection with your plastic surgeon.  It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS

Harvard-trained Board Certified Aesthetic Plastic Surgeon

Dear Haxzel,Your assessment about the acute nasolabial angle is accurate. This can be made more obtuse with a combination of various rhinoplasty techniques and might not need a premaxillary augmentation. Upward rotation of the tip is necessary and it can be achieved with various methods, the one chosen would also be depenent by the frontal view of your face and the width of your alar cartilages. It would be best to evaluate you in person to be able to determine these parameters along with the  elasticity and resilience of your cartilages, the skin thickness and also the other related contours of your face. This way your surgeon is able to come up with a safe, feasible surgical plan that would suit your overall  appearance and look aesthetically pleasing and natural on you. Some offices offer computer imaging as a means of communication about the design of the nose and to determine which one looks best on a particular face. Our patients love this option and it offers an effective platform to discuss details together. It is best to be evaluated by a surgeon  who is very experienced with Rhinoplasty and Board Certified by the American Board of Facial Plastic Surgery or Plastic Surgery.Best Regards in your quest, Dr. Anna PetropoulosBoard Certified Facial Plastic SurgeonNorth Shore Boston

Hello and thank you for your question and sharing your photos. It is necessary to see your standard full face and profile views for a better analysis. You seem to benefit from a tip refinement rhinoplasty, focusing on nasal tip cephalic rotation. An attractive nasolabial angle is 100-110 degrees in women. There are a several techniques available to achieve this, and all have to do with manipulating the alar cartilages and use of cartilage grafting. My best advice is that you discuss your concerns and aesthetic goals with a board-certified plastic surgeon with extensive experience in performing rhinoplasty. I would ask to see before and after pictures of their real patients. It's important that you trust your surgeon's skills and ability to achieve the results you are looking for. In particular, pay attention to your surgeon's experience with rhinoplasty. Best,
Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

It is very difficult to give you good advise without in person evaluation. In general, naso-labial angle can be corrected with a relatively simple surgery. However, whether correction of naso-labial angle or other variation of rhinoplasty would be best suited for your needs can be decided only on the basis of in person evaluation and discussion about your goals. Good luck.

Hax: You do have a pretty sharp, acute nasolabial angle like you say. It usually means your septum is deficient at the bottom, combined with tip cartilages that point down.  Your best result would be a rhinoplasty with caudal septal augmentation which will push the columella down, and additionally you can perform maneuvers like tongue-in-groove or better yet lateral crural overlay (I would recommend lateral crural overlay) to rotate your tip cartilages higher and give your nose a more feminine appearance. The whole nose has to work together, so you might need a hump reduction too.  Best of luck.  

Your nose could be reduced a little but I advise against premaxillary augmentation. You don’t need it at all and I have seen cases that look pretty weird with cartilage grafts in the area.

Excellent question!  Basically we would be filling in that area with additional volume. This can be done a few different ways.  (1) We can possibly inject a filler material to augment the area. This is effective though temporary (but lasts many months).  (2) We can do nose surgery to reposition the tip of your nose to show that area better. Sometimes the problem is that the nose is tilting downward and obstructing the area thus changing the angle.  (3) We can add cartilage, fat, or other materials there during a rhinoplasty (nose surgery) to get the right shape.The next step would be a video consultation to see what is best for you!Best regards from Newton.