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Artefill / Nasal Tip Surgery

Hey. Can nasal tip projection surgery be performed even if there's a small amount of Artefill already in there? If not, I'd want the Artefill removed. I understand this would be a tricky operation, with incision scars resulting. Would there be a possibility of significantly reducing these scars over time (healing, laser, grafts, camouflage make-up etc)? Thanks for any help/opinions. P.S - I know the Artefill was a terrible idea in the first place, so no need to remind me.

Doctor Answers (12)

Artefill and Rhinoplasty

+1

Most likely, the Artefill needs to be left alone, unless it was injected into a plane that is easily accessible at the time of the rhinoplasty. An experienced rhinoplasty surgeon can likely provide you with the look you seek with a variety of techniques at his/her disposal.


Miami Facial Plastic Surgeon
4.5 out of 5 stars 46 reviews

Rhinoplasty with artefill in the nose

+1

While I am not a fan of ArteFill, it should pose no problem to having your nose done. Many people tolerate the ArteFill without any problem. It can be removed to some degree during the rhinoplasty if that is your wish. The incisions should be the standard rhinoplasty incisions. I would avoid any incisions on the outside of the nasal skin just to remove the filler. The oily nature of the nasal skin sets it up for uneven scaring in the tip area. Incisions in this area often require Dermabrasion to help smooth them out.

Brian Maloney, MD, FACS
Atlanta Facial Plastic Surgeon
4.0 out of 5 stars 7 reviews

Arteifill Removal with Nasal Tip Surgery

+1

Yes the Artefill can be removed, if necessary, at the time of tip surgery. I would use the open rhinoplasty technique.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

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Question Cannot Be Properly Answered Without Consultation

+1

Before a wise decision is made, you need to have the benefit of a proper and detailed consultation. That means the doctor knowing the complete history, particularly how long ago the Artefill was placed. He or she needs to examine the interior, and to feel the tip to see if it is soft or firm and whether or not the skin can tolerate yet another operation.

It may be that another filler could be used but before that decision is made, you need to have answers to questions. Particularly, how much more tip enlargement do you want? Is there room for more filler? Are the remaining cartilages strong enough for more surgery?   Will it fit your face?

Computer imaging will help answer that question for you so I strongly recommend that service.

Read books, visit websites and most importantly, consult with a surgeon who is very specialized in nose work and who will take the time with you to help you make the best decision. Sometimes, the best decision is not to do anything, rather than incur complications or further dissatisfaction.

Best wishes.

Robert Kotler, MD, FACS

 

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Artefill and rhinoplasty

+1

You haven't mentioned why the Artefill is a problem for your nose. If it's simply that it didn't achieve the desired tip projection, then there isn't necessarily a reason to remove it. More importantly, removing it may not be a good idea since it could lead to some significant irregularities to the skin. Remember that even during primary rhinoplasty (with no Artefill present), we have to take into account skin thickness and we routinely compensate for it. And in revision rhinoplasty there is often much more scar or irregular framework than anything seen in an Artefill-injected nose and we're able to work with that or work around that.

Unless there is a very strongly compelling reason to attempt its removal (e.g., a medication-resistant granuloma), you may want to be wary of any surgeon who proposes its excision.

Also, don't beat yourself up about having Artefill in the nose. It's no more a bad idea than having a surgical rhinoplasty. 

All the best,

--DCP

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Advanced revision rhinoplasty for an open procedure

+1

It is possible that the Artefill can be partially removed using an open rhinoplasty incision at the same time as your rhinoplasty.  I would use a columellar incision to perform this.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 47 reviews

Artefill removal in the tip.

+1

Yes, the Artefill in the tip can be removed and replaced with cartilage. This can be done in one operation so you are not left with a deformity in the interim.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Artefill / Nasal Tip Surgery

+1

Very hard to advise without more medical info and photos. My guess is to in person research because this could be a very tricky removal. From MIAMI Dr. Darryl J. Blinski, 305 598 0091

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

A significant amount of the Artefill could be removed during rhinoplasty

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If rhinoplasty is indicated, some or most of the Artifell could be removed at the same time.  It is very common for us to remove fillers or implants during rhinoplasty and use cartilage graft to reshape the nose.  

Amir Moradi, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

Raising a Nose Tip previously filled with Artefill

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Regarding: "Artefill / Nasal Tip Surgery
Hey. Can nasal tip projection surgery be performed even if there's a small amount of Artefill already in there? If not, I'd want the Artefill removed. I understand this would be a tricky operation, with incision scars resulting. Would there be a possibility of significantly reducing these scars over time (healing, laser, grafts, camouflage make-up etc)? Thanks for any help/opinions. P.S - I know the Artefill was a terrible idea in the first place, so no need to remind me
."

As you know, ArteFill causes an intense scar reaction. Trying to remove the scar and ArteFill would thin the skin and may deprive it of its blood supply resulting in depressions, irregularities and possibly in ulcerations.

Ideally, the tip of the nose may be raised without having to go through the same area but it would require either a cartilage graft or an implant, the former being preferred.

You need to see a surgeon who is familiar with nose revision surgery.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 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.