Can a lack of cartilage in the nose tip causing drooping be fixed with fillers? (Photos)

Question

I have a lack of cartilage/ weak cartilage in the tip of my nose and it causes my nose to droop (only) when I smile. My nostrils also flare and "rise" causing the drooping to be even more noticable. Can this be fixed with fillers? I find it hard to judge by watching before and after pictures of other people getting fillers because nobody is smiling in those pictures and my main issue is when I smile. I hope you can help me answer my questions.

Nelson Lee Novick, MD · Answer

I have been performing nonsurgical nose jobs using volumizing fillers for well over fifteen years, since the early days using the calcium-based filler, Radiesse. Today we have a number of hyaluronic products for this purpose, including Restylane Lyft, my favorite in my NY office and Hyabell Deep, my go-to in my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available. Originally this quick, simple, relatively inexpensive, and no-significant-downtime procedure was used only for straightening bent or beak-like nasal bridges. Within a few years, however, experienced injectors extended its uses to include treating dorsal spine of the nose irregularities or hanging columellas left after surgical rhinoplasty; asymmetries of the nasal walls; nasal tip clefts; and droopy nasal tips. Italian investigators even developed a special technique, one that I personally use, for not only elevating the tip, but achieving an upward rotation, as well. Treating a droopy tip should not take more than five minutes to perform and typically engenders an immediate "Wow!" reaction. If there is any accompanying upward movement of the tip related to facial expression or flaring of the nostrils, these, too, may be treated quickly and relatively inexpensively and nonsurgically using a couple of droplets of Botox (or Dysport or Xeomin). Be certain consult with a board certified aesthetic physician with experience and expertise in performing nonsurgical nose jobs and make sure to ask to see his/her before and after photos before agreeing to proceed. Best of luck.

Jason Emer, MD · Answer

I recommend getting a formal evaluation with a cosmetic dermatologist to go over your desired results. Facial fillers (voluma, restylane, juvederm) along with Botox can be used to improve the symmetry of the nose. Surgery would be needed to improve nostrils or overall shape. See an expert. Best, Dr. Emer

Eric M. Joseph, MD · Answer

Your photos appear to reveal a hanging columella on profile, and a pleasing appearance on front view. Your hanging columella may be indicative of poor nasal tip support, and that may contribute to droopiness with smiling. Repair of a droopy nasal tip may require surgery. Hope this helps. Dr Joseph

Shaun Patel, MD · Answer

Nonsurgical rhinoplasty using fillers has a very specific role in my practice. It helps me smooth the appearance of the bridge of the nose as well as add a little volume to the nasal tip and lip it up. It is not an replacement for rhinoplasty in the majority of cases though. A neuromodulator like Botox or Dysport could also be used to prevent nasal tip depression with smiling.

Can a lack of cartilage in the nose tip causing drooping be fixed with fillers? (Photos)

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