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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
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The nasal septum is the wall that divides the inside of the nose into a left airway and a right airway.  When the septum doesn't sit in the middle, it can obstruct airflow through the nose instead of guiding the airflow.  We then call it a "deviated septum," and that deviated or crooked septum can be straightened during a rhinoplasty.

Most commonly, the deviation of the septum cannot be seen from the outside of the nose.  The deviation that obstructs the airflow is deeper inside the nose, where you can't see it.  This patient's septum was so bad that you could see it before surgery.


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Questioner: My nose looks like it's cut in the middle, and looks like an extension?
From the picture you can tell that the surgeon made a mess. Looking at the picture, do you think a surgery is necessary?
(Questioner submitted photos)

Dr. Denenberg's answer: No fillers, please! But I believe improvements can be made.
Hi,

I know it's just one photo that you posted, but there are generally ways to improve the areas that you complain about in a revision rhinoplasty. 

The "dents" can often be filled in with cartilage grafting, and they can be made further inconspicuous by lowering prominences of bone next to the dents.

Then, I don't know whether this bothers you, but the tip of your nose can be raised, too. Whenever a nose is a little smaller, the bothersome features often are less noticeable. I shortened your nose in my morph.

My guess is that the doctor who recommended fillers or fat grafting does not perform revision rhinoplasty. Respectfully, I just think that's not a good solution for what I see in your photo.

Link to this question on RealSelf.com