Would I be able to fix my caved in nose? (Photos)

Hello:Thank you for your question regarding your deviated septum and for posting photos of what it is that is concerning you with the form and function of your nose. I do see the concavity you are referring to and it also looks as if the tip of your nose is beginning to shift. You are most likely a candidate for a revision rhinoplasty. The correction of a deviated septum involves the realignment of the nasal wall between your nostrils. This is called the septum. The technical term to correct and straighten a deviated septum is called septoplasty surgery. A deviated septum is the most common condition which not only impedes your breathing but also contributes to a crooked shape or concavity.There is no one size fits all approach to nose job surgery. I often tell patients, "Shakespeare never wrote a sonnet about the nose." In my experience of over 20 years in the field of facial plastic surgery, I can assure you that when considering a secondary or third revision to your nose, experience and board certification in facial plastic surgery is of the utmost importance. I would encourage you to do your research on surgeons that specialize in revision rhinoplasty and to seek out the advice of more than one surgeon when you go on consultations. I am including a website link that discusses revision rhinoplasty as well as a video that shows a patient who I see for their 3 week follow-up appointment. If you have any questions, please feel free to contact our New York City office and we would be happy to answer as many of your questions as we can.Sincerely,Philip J. Miller, MD, FACSDouble Board Certified Facial Plastic Surgeon

Hi and thanks for your question and photos.  You appear to have a depressed upper lateral cartilage on the left side which is causing the depression.  I would borrow cartilage from your septum if there is still adequate cartilage there or from behind your ear to do an onlay graft over the existing upper lateral cartilage.  

I don't think going back to either surgeon would be a good idea.  The asymmetry was created by them and it's not from septal cartilage work.  You would benefit most from a revision rhinoplasty by an experienced rhinoplasty surgeon, who should give you precise understanding of why your nose looks the way it looks now and what would be needed to correct these problems.  Fillers can help but only if you never wanted to have another operation.  The best thing to do is to be evaluated by a board certified plastic surgeon, who has experience in correcting the problems that you have.  Good luck!

The left side of your nose appear to show issues relating to the left upper lateral cartilage and the left lower lateral cartilage resulting in lateral wall insufficiency with a caved in appearance. Cartilage grafts via an open approach rhinoplasty can offer you correction and improvement in appearance. I would favor actual corrective nasal surgery over nasal fillers. An expert "second" opinion from a reputable, experienced rhinoplasty surgeon may be appropriate, though I would discuss your concerns with your original surgeon as well and ask for recommendations.

This looks mostly like a depression of the upper lateral cartilage in this area.  It can be corrected with a spreader graft which involves taking cartilage from your septum or ear to place between the septum and upper lateral cartilage. If there are no breathing problems one could simply place some bruised cartilage beneath this area in a precise pocket. If you didn't want a permanent surgical correction you could just consider fillers for the time being.

 The caved- in the component appears to be a concave upper lateral cartilage on the patient's left side.    A spreader graft composed of the patient's own cartilage can be placed in this area to build it out so that it looks like the opposite side.  This is a rhinoplasty procedure, not a septoplasty procedure.  A rhinoplasty procedure is not performed for a deviated septum.   For more information about the differences between a rhinoplasty and septoplasty, please see the video below 

It is difficult to say without seeing your preoperative photos and knowing exactly what was performed.  Regardless, there certainly are options for addressing your concerns.  I strongly discourage the use of fillers in the nose.  They are somewhat unpredictable and can cause long-term issues, particularly if a surgical procedure is ever required after filler placement.  As always, it is important to personally consult with a board-certified Plastic Surgeon who specializes in rhinoplasty