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