There are 3 factors which affects the appearance of the nose: skin, cartilage and bones. You were not very specific in describing the location and appearance of the dent, so I'll discuss a little on all 3:
- Skin - scars from previous trauma, permanent wrinkle lines due to frequent nose rubbing from allergic rhinitis, or even acne scars can cause a dent or depression on the nose. Typically these kinds of dents can be reduced with lasers, resurfacing or scar revision surgeries.
- Cartilage - cartilage is found in the lower 2/3 of the nose. There are 2 pairs of upper and lower lateral cartilages, as well as the nasal septum that may be visible, especially if your skin is thin. Any defect/ contour deformity in these cartilages may show up through thin skin. You may not even have a history of trauma or injury. Treatment options include simple camouflage with fillers, or surgery to correct the cartilage deformity. The latter is particularly worth considering if they are causing you breathing problems as well.
- Bones - these are located in the upper 1/3 of the nose. Previous nasal fractures and trauma can cause the bones to be crooked or dented. Once again options to treat include fillers, or surgery to re position the bones in their correct position.
The most common cause of a dent in the nose would be from trauma to the nasal bone that has been missed or forgotten. Sometimes, with age, the dent becomes more obvious as the traumatised part does not grow normally. If the dent has been there since birth, it could be a congenital dent, where one small part of the nose structure did not develop as well.
Usually, after an examination to determine where the dent actually is, I do a simple nasal scope too in clinic to see if the internal nasal structures are also affected. Rarely, a CT scan of the nose is needed.
Most nasal dents can be corrected nowadays if you choose to, but it would be important to correct that after a good understanding of which structures are affected, and to balance the cosmetic and functional aspects of the nose.
Dr Lynne Lim
Thank you for your question. I'm not exactly sure what you are referring to when you mention a huge dent in the nose. As you rightly pointed out, one of the common causes for depressions in the nose is from traumatic injury to the nasal bone.
If you are sure that there is no previous trauma to the nose, the other possibility is acne scars. Depending on the severity this can be treated with CO2 lasers, fillers or fat grafts. I had a patient once who had a depression in the tip of the nose, known as a bifid nasal tip (see below) and this could be caused by the separation of the nasal cartilages at the tip. This can be easily corrected by a tip rhinoplasty where sutures are used to align the cartilages and cartilage grafts are added to create additional tip support.
Bifid Nasal Tip. (Image from www.rhinoplastyarchive.com)
I hope this answers your questions. I would recommend an in-person consultation with an experienced plastic surgeon who is able to manage both the functional aspects and cosmetic aspects of rhinoplasty.
Have a great weekend ahead!
Dr. Terence Goh
Plastic Surgeon, Singapore
The information provided is purely for educational purposes and does not constitute medical advice or create any physician/patient relationship. Results may vary between individuals.
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It is likely that you’re referring to a horizontal skin crease on the nose bridge area.
This is actually a skin crease from childhood due to frequent “pushing” of the nose upwards. This is often done by the child with a very sensitive nose , who might have sinus allergies and the common early morning runny nose and sneezing. This is also known as the “salute sign” , when the child uses the hand and finger to push the nostrils upwards. This causes the horizontal skin crease on the nose.
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