Can my upturned nose and piggy nose be fixed with a filler? (Photo)

Hello and thank you for your question. It sounds like your biggest concern is your over-rotated nasal tip resulting and less defined nasal tip. With over-rotation of the tip, you typically get increased nostril show, as in your case. These are due in large part to the underlying anatomy present- at the tip, the structural framework of your nose is made of cartilage. Filler would not be adequate in your case, since you would need to alter this underlying framework- specifically you would need to de-rotate the nose and refine the appearance of the tip. Addressing the shape of the nose (particularly the tip) is actually one of the most common reasons people seek out and undergo a rhinoplasty procedure.

In addition to addressing your aesthetic concerns, your septal cartilage (or an off-the-shelf alternative) would be harvested (removed) and turned into multiple cartilage grafts, which would then be secured into different areas of your nose for structural support, including in the columella (middle bottom portion of your nose between your nostrils) to really reinforce the tip and alae, and prevent recurrence of the alar retraction.

The open approach is very effective in facilitating complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look. Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery. I would only recommend going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible.

Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the photos and description provided.

Dr. Donald Groves, our expert facial plastic surgeon, has extensive training and experience with complex rhinoplasty surgeries, so I’d recommend for you to come see him (or another plastic surgeon who is extremely comfortable with rhinoplasties) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!

Dr. Emer

Dr. David M. Tauber, MD - DeLucaPlasticSurgery.com - Albany, NYA non-surgical rhinoplasty uses fillers off-label to camouflage small deformities by adding volume to the nose. This procedure works well for caucasian noses with small to moderate bumps.   
In contrast, an ethnic nose like yours is usually lacks a strong dorsal profile and lacks tip refinement. The nose in the pictures you shared is no exception. Most of these characteristics, including your complaints of a piggy nasal tip, are not able to be fixed with fillers alone.  For patients like you, I recommend a surgical rhinoplasty that utilizes grafting techniques to strengthen the projection of the tip and raise the dorsum — lengthening the nose and strengthening the dorsal profile. Next, suture techniques are used to refine and reposition the tip. This is a powerful procedure that adds, removes, or re-positions tissue in the nose for better aesthetics - often completely reshaping the nose.  
These are big maneuvers that are often intended to create millimeter changes to the shape of the nose once it heals. The thickness of the nose skin can affect the overall result, however, an improvement can be obtained for most patients.Click the link to see more info on rhinoplasty surgery: tiny.cc/rhinoplastyA detailed examination will help delineate the best surgical option and provide you a custom quote for your situation.

Depending on your examination, permanent nonsurgical rhinoplastic treatments with Silikon-1000 may be considered for nostril lowering. Your cheek and chin enhancement appear pleasing, and a dissolving enzyme may not be the next best step. Thank you. Dr Joseph