My nose is uneven and bends to the left. Could threads be a solution? (Photo)

Question

I had a closed rhinoplasty 2 years ago. I am not happy with the results. My nose is uneven and bends to the left. Which procedure would you recommend to solve the problem? Fillers, threads, new surgery?

Anna Chacon, MD, FAAD · Answer

I can understand why this is frustrating, particularly after already going through rhinoplasty and still feeling that your nose is deviated. Looking at the photos, there does appear to be some asymmetry and a deviation of the nasal structure toward the left. However, a photograph cannot tell us whether the underlying issue is primarily cartilage, bone, the septum, scar tissue, or a combination of these.

Because you are two years out from your rhinoplasty, the result should generally be considered well beyond the usual early healing period. At this point, if the remaining problem is structural, I would be cautious about trying to camouflage it with threads or filler.

Threads: I would not consider threads the ideal solution for a nose that is structurally bent. They may provide some temporary contour or support in selected situations, but they cannot reliably straighten an underlying deviated nasal framework. There are also risks such as irregularity, infection, migration, and scarring.

Filler: Filler can sometimes camouflage a mild indentation or create the appearance of a straighter nasal profile. It does not actually straighten the nose. In a previously operated nose, I would be particularly conservative because the blood supply and anatomy may have been altered by the prior surgery. Although uncommon, vascular complications from nasal filler can be serious.

Revision rhinoplasty: If the nose is genuinely deviated because of the underlying cartilage, bone, or septal framework, revision rhinoplasty is the option that can actually address the structural cause. Revision surgery can be more complex than the original procedure because of scar tissue and altered anatomy, and sometimes cartilage grafting is needed to provide adequate support.

One other important point is that a nose can look crooked externally even when the problem isn't entirely cosmetic. A deviated septum or asymmetric internal structures can contribute to both the appearance and breathing function. If you have difficulty breathing through one side, that would be particularly relevant when deciding how to approach the correction.

Based on the photos alone, I wouldn't recommend choosing threads or filler simply to avoid another surgery. If the goal is to actually straighten the nose rather than camouflage the deviation, the treatment needs to address whatever structural component is causing it. A revision procedure may therefore be more appropriate if a structural problem is confirmed, while a small amount of filler could have a role only when the remaining issue is a minor contour irregularity rather than true deviation.

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have relatively thin nasal skin and it's possible that the crooked appearance you refer to is due to a small indentation along the left side wall of your nose. If this is true, depending on your examination, microdroplet Silikon-1000 injections maybe considered for permanently achieving a nasal appearance. I hope this helps! Sincerely, Dr Joseph

My nose is uneven and bends to the left. Could threads be a solution? (Photo)

Answers (2)

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