I have a dent in the tip of my nose. Any suggestions? (photos)

It feels and looks like the tip of my nose is missing cartilage straight down the middle which causes the dent. Is there any non-surgical options or would surgery be the better solution? I'm not sure what could be done to fix the issue.

Doctor Answers 9

Surgery to fix the dent in the tip of the nose

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The dent in the photographs represents a cleavage plane between the left and right lower lateral cartilages of the nasal tip. The cleavage is just a little more deeper than in most patients. To get rid of this cleavage/ dent requires suture techniques applied to the lower lateral cartilages of the nasal tip to blunt this along with a cartilage graft placed in this area to build up the deficiency.


Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Depending on your examination, microdroplet Silikon-1000 may be considered for the indentations on your nasal tip.

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Based on your photos, you appear to have thin skin and visible asymmetrical tip cartilages. The indent or cleft is between your lower lateral tip cartilages on each side. Depending on your examination, adding volume to this area may lead to improvement. Our experience with non-surgical rhinoplasty is with Silikon-1000, an off-label filler for permanent results.

Thank you.

Dr Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Rhinoplasty, Toronto Plastic Surgeon Dr. Adibfar

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Hello 
the nose dent you are referring to is the seperation of the two "lower lateral cartilages" of the nose which are noticeable in a thin skin nose.
Your options would be:
1) surgical rhinoplasty to re approximate the cartilages with sutures
2) non surgical use of fillers ( hyaluronic acid) to inject between the skin and cartilage and therefore camouflage the cartilages .  This is more immediate, less expensive but may have to get redone in the future.
Thank you

Correcting a dent/cleft in the tip of your nose

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The dent or cleft in the middle of your nasal tip is due to the shape of your underlying nasal tip cartilages. There is normally a separation between the right and left cartilages but is often not quite as visible. However, with thin nasal skin, the shape of the underlying cartilage can be more apparent in some people. This could be corrected through a rhinoplasty to help reshape and reposition these cartilages to make the depression less noticeable. Good luck! 

Sachin S. Pawar, MD
Milwaukee Facial Plastic Surgeon
5.0 out of 5 stars 35 reviews

A cleft between the lower lateral cartilages can be corrected with a tip rhinoplasty.

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The dent you referred to is actually separation of the two cartilages the form the nasal tip. This can be corrected easily by way of a tip rhinoplasty.

Against fillers

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Do not even think about fillers, NO serious and professional surgeon in the world would advice such thing (potentially destructive and impediment for future corrections) in rhinoplasties, much less in complex congenital issues like yours.

You suffer two congenital conditions:
-sever cleft tip deformity: this needs correction by means of plasties at the domes, plications to the midline and eventually some cartilage grafting
-partial invertion at the dome and dents of congenital origin distorting the normal shape of one alar cartilage: this needs correction by plasties but, much likely, the intraoperative achievement might be poor and the surgeo (if experienced and good one) will replace the deformed cartilage by a new and freshly harvested one (ear's concha as donor site) taylored to fit the contralateral alar cartilage

All that needs open approach.

Your congenital and uncommon condition requires the hands of a very very good and meticulous surgeon, a doctor with experience in inverted alar cartilages and complex tip works and grafting.

Alejandro Nogueira, MD
Spain Plastic Surgeon

Rhinoplasty

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It can certainly be improved/fixed. An experienced Board Certified Plastic Surgeon might use suturing techniques among other methods. In-person consultation is necessary. 


All the best,

Dr. Results
Miami, FL

Tip issue

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If you want a noninvasive non-permanent treatment, then fillers are ok. If you want a more permanent option, then a tip procedure to bring the domes closer together would be reasonable.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Dent in Nose

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I just operated on a patient to correct that defect.  See a Board Certified Plastic Surgeon who is highly experienced to discuss your options.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 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.