Why is There an Indent in my Nostril when I Smile?

Question

When I smile I get this line/dent in my nose. What is it called? Why do I have it? Its only on the left side of my nose not the other. Ive never had rhinoplasty before. Is it fixable or is that just how my nose is shaped?

Michael A. Persky, MD · Answer

Hi Miss Mex,

	It appears that you may have an inverted left lower lateral nasal cartilage that is concave instead of the normal convex.  This would have to be confirmed on an actual physical examination.  If that is the case, and it bothers you aesthetically, it can be corrected by nasal surgery.  The offending piece of cartilage is excised, flipped, and then sutured back in place correcting the problem.  Choose your rhinoplasty surgeon most carefully.  Good luck and be well.

	Dr. P

Ronald J. Edelson, MD · Answer

That little depression is known as the soft triangle of the nose and, as you note, it is more noticeable on one side than the other. Do not try to get it fixed. It is actually a desirable feature of a nicely shaped nose. Overall your nose looks quite nice so don't mess with it, you would be making a mistake.

Kenneth Hughes, MD · Answer

This is a bit subtle, but this can be improved with a variety of approaches. I am not sure I would necessarily recommend a rhinoplasty for this, but I would have to examine you in animation and in relaxation. Find a plastic surgeon who performs hundreds of rhinoplasties each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

William Portuese, MD · Answer

The nostril indention can be caused by the a concave or inverted lower lateral cartilage on the affected side, and a active depressor septae ligament the tethers the tip downwards upon animation. Both of these can be addressed with a rhinoplasty procedure.

David C. Mabrie, MD · Answer

Fillers, like Restylane, Radiesse, and occasionally Arterfill, are great options for contouring the nose and improving nasal symmetry.

	Non-surgical Rhinoplasty is an advanced filler technique so look for someone who specializes in the procedure. 

	The fillers may be used to fill dents and concavities or add definition to the tip, similar to the effect of a tip graft.   They last one year in total, half of the filler is absorbed at 6 months and many patients will have touch-up appointments then.

	Good luck,

	Dr. M.

Stephen Weber MD, FACS · Answer

The indent you're referring to is your alar groove. While it might be more pronounced on your left side it is dramatically enhanced by the lighting in the first two photos you've posted. The lighting "flattens" the right side of your nose and enhances shadowing on the left side in the first two photos. Filler could potentially soften this but you're best off ignoring it. You have a very attractive face and everyone notices your eyes and brows and are unaware of the groove that troubles you. I hope this information is helpful.

	Stephen Weber MD, FACS

	Lone Tree Facial Plastic Surgeon

Jeffrey Zwiren, MD · Answer

The indentation of your nose is a normal variant.  Rhinoplasty would not be expected to correct this problem with any degree of certainty.

Steven Wallach, MD · Answer

This looks like a normal variant. I would run far away if someone says that you should have an operation to improve this.  Enjoy life!

Richard W. Fleming, MD (retired) · Answer

The asymmetry you have observed, regardless of cause (there are several), can be improved with rhinoplasty surgery. Consult with an experienced specialist who will examine you and describe alternative treatments.

Jay M. Pensler, MD - Account Suspended · Answer

The indentation you are referring to is the Alar groove.This is a normal structure.The Alar groove deepens when you smile.It is not uncommon for some asymmetry between the right and left side of your nose to exist.

Why is There an Indent in my Nostril when I Smile?

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