Menlo Park Facial Plastic Surgeons

Can You Rasp Nose After Ear Cartilage Has Been Placed on Profile?

I had a revision rhinoplasty with ear cartilage added to profile and the length extended to correct all the irregularities. It has been 12 days since the surgery and my nose is HUGE and it looks more like a roman nose than a straight nose. If I have a revision is it possible to rasp the nose down with ear cartilage on it? Also, does the nose get that much bigger from cartilage layed on it. What are the dimensions of a nose. It seems to me the surgeon did not give me a nose that fit my face

Thanks for the question. At 12 days out, it is very early in the healing process after revision rhinoplasty and there is quite a bit of swelling which will dissipate over the next several weeks to months. Do not fret at this point as you have a long way to go. A good rule of thumb is to wait around 9-12 months before considering revision rhinoplasty. At that point, if you feel the nasal bridge is too high, the cartilage which has been placed can be shaved down or removed and replaced, depending on what exactly was done at the last surgery. A rasp is used to reduce the height of the nasal bones or file down small bony irregularities. Cartilage is better addressed with sharper instruments.

If there are no other issues with the nose, it's possible that this revision can be done through a closed (endonasal) approach with shorter postoperative recovery time. You can address your concerns with the surgeon who performed your revision surgery but, most of all, be patient...

Best regards,

Dr. Mehta

Umang Mehta, MD

Bay Area Facial Plastic Surgeon

How Long Should I Wait to Have Rhinoplasty After Having Fillers on my Nose?

I hv been using non-permanent fillers for my nose (tip & bridge) for abt 2 yrs now (4 mths in btwn) My last procedure for fillers was done on 2nd Sept. I want to explore Rhinoplasty instead as I am tired of getting d jabs n wld like a more permanent look. I m planning for d procedure in Mar 2012. Consultations scheduled end Nov. Is d time span good enuf for d effects of my fillers to wear off for d consult in Nov n procedure in Mar? If no, how long should I have to wait before I can proceed?

Hello Kauakea,

Thanks very much for the question, one I get very frequently from patients seeking a Nonsurgical Rhinoplasty. Temporary filler placed in the nose can improve the shape of the nose for 9 to 18 months, though the correction may be present even longer. Fillers in the nose seem to last longer than some other areas of the face (e.g. around the mouth), likely due to the fact that the nose doesn't move much with animation, talking, and chewing. There are also permanent fillers which can be used, though this must be performed very carefully and judiciously. 

Getting back to your question, it would be helpful to know which filler was used. If one of the Hyaluronic Acid (HA) fillers such as Restylane, Perlane, Juvederm Ultra, Juvederm Ultra Plus, or Prevelle were used, the filler can be dissolved at any time with a few injections of hyaluronidase. You could have this reversal performed and have your rhinoplasty consultation and computer imaging done the following day. If on the other hand, your physician injected a non-HA filler such as Radiesse, the results can last for over a year. In my experience, rhinoplasty can be more time-consuming after Radiesse injection as the tissue planes are a bit more "sticky." In any case, be sure to do your due diligence and consult with surgeons specializing in rhinoplasty. 

Best of luck,

Dr. Mehta

Umang Mehta, MD

Bay Area Facial Plastic Surgeon

I Want To Soften My Bridge. Am I a Canidate for a Non Surgical Nose Job?

Im not looking for the "perfect" nose, but i wanted the bridge to appear softer. Please let me know if i am a candidate for non surgical nose job, thanks :)

Hi Tiffany,

The best advice I can give you is to seek a consultation with a rhinoplasty surgeon who performs both traditional surgical rhinoplasty as well as nonsurgical rhinoplasty. Nonsurgical rhinoplasty refers to the use of fillers to augment portions of the nose to hide contour irregularities as well as camouflage bumps.

Placing filler above and below your bump would hide the bump but, on the flip side, would make your bridge appear higher. With the use of computer imaging, you could see if you like the higher bridge or if you would prefer removing the bump through surgery. If nothing else, it's neat to see a "sneak preview" of your new nose. Depending on what exactly needed to be done to your nose, a closed or endonasal rhinoplasty may be appropriate. If you have any difficulty breathing through your nose, this could also be corrected and a portion of your surgery may be offset by insurance.

If you do decide to use filler, I would highly suggest you try Restylane, Perlane, or Juvederm (Ultra or Ultra Plus) the first time around, as these products can be dissolved immediately with injection of an enzyme called hyaluronidase, if you did not like the effects. In my experience, these fillers last quite a while in the nose, longer than they do in other parts of the face. The procedure takes just a few minutes to perform and can be comfortably done in the office after placement of numbing cream. 

There is a "Virtual Rhinoplasty" app on my website which allows you to morph and download your photos yourself or your physician should be able to do this with you during your consultation. 

Best regards,

Dr. Mehta

Umang Mehta, MD

Bay Area Facial Plastic Surgeon