Rhinoplasty or Filler? (photo)

Can you please tell me if I need surgery I cant tell if i need rhinoplastery or a filler. When I look at my photos I see two different people therefore I am unsure if I need it. I have had four consultations with surgeons, one was happy to perform surgery, one said it was a septum problem. While the following two said I looked fine and didn't need surgery. All photos below were taken after my nose was broken. Can you please tell me what you think.

Doctor Answers 14

Crookedness and injectables

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Soft tissue fillers can be used in certain situations to correct deformities of the nose. One of the more common uses is to fill depressions of the nose. However, you appear to have a crooked nose and this may be a result of the trauma you sustained. Filler will generally not adequately address the deviation and will not improve your nasal airway obstruction if present as a result of the deviation.

With regard to nasal deviation, three possibilities generally exist:
1. Visible external nasal deviation with internal septal deviation
2. No visible external nasal deviation (nose appears straight) with internal septal deviation
3. No visible external nasal deviation (nose appears straight) without internal septal deviation.

In your case, your external nose appears to be deviated to your left and it is possible that you also have a deviated septum internally. This could be confirmed during a consultation including an examination of your nose. Additionally, there are other areas of the nose that can be the cause of structural obstruction including the external valves, the internal valves and the turbinates. Physiologic problems can also cause nasal airway obstruction in the absence of a structural deformity - these include problems such as allergic rhinitis.

It is possible to correct the nasal airway obstruction at the same time as improving the appearance of your nose. Addressing a deviated septum that affects nasal airflow can also improve the external appearance of your nose; however, correcting the crooked nose typically requires other technical maneuvers in addition to septoplasty to obtain the best possible cosmetic result.

You should see seek the opinion of a board certified plastic surgeon to have an evaluation of your nose and nasal airway.

Rhinoplasty or Filler?

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    There is a crooked element to your nose, which would be better remedied by a surgery.  However, filler can be used to camouflage the crooked nature to an extent.  Kenneth Hughes, MD Los Angeles, CA

Rhinoplasty for broken nose

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The pictures showed a twisted and fractured nose to  the patient's  left side, and a inwardly deviated right upper lateral cartilage. From the pictures presented,  there could be a deviated nasal septum. A deviated septum is only repaired when there is significant breathing difficulty out of the nose and is not done for cosmetic purposes. A rhinoplasty would address straightening the nasal bones with osteotomies, and placing a spreader graft in the depressed and concave right upper lateral cartilage area. Please see the  link below for patient's in our practice where we have repaired  their crooked nose.Fillers for this nose would be inappropriate.

Fillers can sometimes be used to change the nose and avoid surgery.

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In your particular case it is impossible to say whether or not fillers or suitable option. The surgeon must know what you don't like about the nose and what you want to look like. I think video imaging gives you the best opportunity of communicating with the surgeon.

Septorhinoplasty Is Needed For Correction Of Deviated Nose

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The asymmetry in your nose is a result of deviations from the nasal bone down  through the septum. This is a surgical problem if you want to improve your breathing, make it straighter, or both. It is not clear from your inquiry as to what bothers you and exactly what you want to achieve. At the least, this is not a simple filler fix problem.

Rhinoplasty vs Filler

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It appears that there is asymmetry in your nose, particularly with the indentation on the right nasal wall.  The first question is whether you have any difficulties breathing through your nose.  The second question is what you are looking to achieve.  A thorough evaluation of both the inside and outside of your nose is recommended to determine the underlying anatomy and realistic expectations.  Computer imaging will be helpful in visualizing your results.  Please consult with a board certified specialist who can assist you in achieving the results you seek.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Filler vs Rhinoplasty

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The answer to your question really depends on what you want to accomplish.  If the issue is your breathing problems, then clearly what you need is work on your septum, bones and other internal issues.  Now if your issue is that your nose is crooked that's a different issue.  You have two options.  You can certainly correct it with surgery.  While total correction is difficult you can improve the appearance for sure.  The other option is using filler to camouflage the crookedness.  It will make your nose slightly wider but with little downtime you can have moderate improvement.  Hope that helps

Rhinoplasty for the deviated uneven nose with a bulbous tip.

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Rhinoplasty for the deviated uneven nose with a bulbous tip can be done especially if u have a breathing problem. But if you think u look fine leave it alone.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

A Non-Surgical Rhinoplasty may lead to a straighter appearance of your nose after trauma.

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I reviewed your photos:

You appear to have an indentation in the middle of your bridge on both sides. The indentation is deeper on your right side which leads to a crooked appearance. If your breathing is fine, and if you're looking for improved symmetry on front view, this may be treated without surgery. My personal preference is to use Silikon-1000, an off-label filler for permanent results.

Hope this helps you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 430 reviews

Correction of nasal deformities after fracture

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Thank you for your question Tiler.  On the pictures you have posted there is an obvious tilt to the nose from the frontal view.  This is occasionally congenital, but often occurs as a result of trauma.  While fillers may temporarily alleviate small asymmetries in the nose, a crookedness such as this one would require surgical correction including resetting the bones.  Ultimately, the choice to proceed with surgery is in your hands and should depend on multiple factors such as how unhappy you are with its appearance, what the success rate of correction would be for your particular aesthetic desires, and your willingness to accept risks and postoperative healing times that surgery would require.

Behrooz Torkian, MD
Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.