Would injectable’s be able to help with my asymmetries in my nose tip? (photos)

Question

I had a revision rhinoplasty in 2020 and have concerns with the asymmetry in my nostrils. Hoping injections could bring out my right nostril more. I was told I’m not able to have anymore revision rhinoplasty procedures as my skin is too thin. Any other options?

Jason Emer, MD · Answer

Hello and thank you for your question. It sounds like your biggest concern is your nasal tip, particularly the shape and the asymmetry of your tip and your nostrils, as you mentioned. Addressing the shape of the nose (particularly the nasal tip) is one of the most common reasons people seek out and undergo a rhinoplasty or revision rhinoplasty procedure. There are actually certain maneuvers which can be performed during rhinoplasty surgery in patients with thin skin to soften the appearance of the underlying structures and improve the overall symmetry at the tip/bridge- but the majority of surgeons are not even aware these maneuvers exist! Given you've previously had a rhinoplasty, and there is no doubt extensive scar tissue present in your tip contributing to the asymmetry, an open septorhinoplasty can best address the entire nose, and is particularly effective for addressing the tip shape, size, and symmetry.

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 prevent recurrence of the asymmetry.

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

Andrew Miller, MD · Answer

After previous rhinoplasty, injections can often make improvements in contour of the nose. I can't say if filler can change your nostril much, but it's a much easier procedure to go through compared to revision rhinoplasty. Be sure to see an expert injector to have this done.

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have a flat area involving your right tip. Depending on your examination, microdroplet Silikon-1000 injections may be considered for improving upon your tip symmetry. Hope this helps! Dr Joseph

Onir Spiegel, DDS, PhD · Answer

Hyaluronic acid fillers, like Versa, RHA, Juvederm, and Restylane are a perfect way to correct most nose deformities, especially little bumps, and tip deformities. Make sure to go to a doctor that does many of these and ensure to have your chin assessed before injecting to keep the chin and nose in balance!

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Afternoon! Injectables can work to assist with asymmetries in the nasal tip. They aren't permanent, as you may know, so there is some upkeep. Additionally, they can create scarring which may be tough to treat in the future. Too thin of skin is not a contraindication to revision rhinoplasty unless there is severe compromise of the blood supply. To prevent asymmetries in thin skin noses, it's important to have well-contoured grafts and camouflage in the form of fascia, usually from the temple area. Seek consultation with a facial plastic surgeon comfortable with revision rhinoplasty. Hope this is helpful to you!

Barry Kusman, MD, FACS (retired) · Answer

A little neuromodulator placed at the base of your nose may be worth a try as raising the tip of the nose may help a little with the asymmetry.

Would injectable’s be able to help with my asymmetries in my nose tip? (photos)

Answers (6)

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