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Deviated Nasal Implant - Can a Filler Help?

About 8 yrs. ago I had a rhinoplasty in which the surgeon put in an L-shaped implant in my nose. That implant has shifted slightly to the left over these years giving my nose asymmetry at the top where the nose meets the junction of eyes. I visited a renowned surgeon in UK and he mentioned that an injectable filler may be able to solve this problem. The implant is silicone. I am wondering if this is a safe procedure and if I were to do this in the US who would be the best surgeon/doctor for it?

Doctor Answers (13)

Nonsurgical Nasal Injections to Improve Appearance after Rhinoplasty Implant

+3

Hi Rocketmanel San Francisco in San Francisco, California

First, be very careful with any injections into the nose. The nose is very susceptible to color changes, discoloration, swelling, blood flow, pain, numbness, and other potential complications with inappropriate injections into the nose.

There isn't a filler on the market currently that is FDA approved for injection into the nose. Everything is being used off-label. Fillers should never be placed into the tip of the nose, since complications may more likely occur at the nasal tip. Fillers should only placed in the bridge to help smooth contour irregularities and to provide augmentation. Fillers which have been used for nonsurgical rhinoplasty include Radiesse and hyaluronic acids.

Nasal injections after having a silicone or goretex implant may contribute to implant infection. If the implant becomes infected, then it will need to be removed and your nose may end up looking worse.

Technically, any physician could potentially treat a patient by cosmetic injections of Restylane into the nose. However, laws vary by state. Generally, one should be treated by someone who has extensive training & experience with nasal procedures and rhinoplasty, such as plastic surgeons and facial plastic surgeons. Only after a comprehensive evaluation can a surgeon help determine appropriate options for you. Best of luck.

Dr. Chaboki


Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 48 reviews

Deviated Nasal Implant - Can a Filler Help?

+3

Worth the try but risks are always present. Best to see the surgeon to discuss the risks in detail. From MIAMI Dr. Darryl J. Blinski

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

Dont do it

+3

I would urge you to avoid injections in your situation due to the implant.  Injection of anything around the silicone implant may introduce bacteria and get the implant infected.  If you had cartilage instead of the implant then a non surgical revision rhinoplasty with Restylane would be OK but with the implant, you may end up with problems. 

Shervin Naderi, MD, FACS
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 37 reviews

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Not a big fan of nasal fillers

+2
I personally am not a big fan of filler in the nose. I would recommend seeing a surgeon experienced in revision rhinoplasty. More than likely, they will recommend removing the implant and replacing it with your own cartilage. Please see someone with extensive experience in revision rhinoplasty as this can be a very difficult situation to correct. Ultimately, for a lifetime correction, you will want your own cartilage to replace the silicone implant.
Andrew C. Campbell, M.D.
Board Certified Facial Plastic Surgeon

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.5 out of 5 stars 9 reviews

No Injections in Areas of Facial Implants, Including the Nose

+2

Hi Rocket,

By all means do not have filler injections in your nose where your silicone implant is located.  The capsule around an implant is avascular and a serious infection can occur.  Best to have your implant surgically removed and replaced with your own cartilage or possibly a Medpor Porex nasal implant.  Good luck and be well.


Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Asymmetry of Nasal Implant

+2

You have a few options.  First, you can have the implant removed.  However, then you are left with the original defect.  Second, you have have the implant revised, but this would require another surgery.  Finally, you can use filler to disguise the asymmetry.  Fillers in the nose are becoming more popular as the are immediately effective and less invasive than surgery.

 

Good Luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 57 reviews

Filler for nose

+2

If your implant is shifting, you may want to redo it. If you do not then a filler is a temporary solution to soften the deviation. I would go to a rhinoplasty surgeon.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Filler after rhinoplasty

+2

I would use caution when injecting material in an area where there is a foreign implant.  If you seed the implant with bacteria it can get infected and you will need to have the silicone graft removed.  Regardless, I recommend you go to an experienced surgeon who has a lot of experience injecting and stays relatively superficial, just under the skin.  From your front view, your asymmetry is not too significant so it shouldn't take a lot of filler to fix.

Dr. Cat Begovic M.D.

Catherine Huang-Begovic, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 5 reviews

Filler for deviated nose with an implant.

+2

You can have this filled with juviderm which goes in the deep dermis and not into the implant cavity with a minimal risk of infection.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Fillers around silicone implant

+2

I would agree with my colleague that injecting a filler where a silastic implant has been placed is really increasing the risk of implant infection/extrusion.

Liquid silicone is especially technique sensitive and can migrate, so many of us do not recommend it. Liquid silicone has also never been approved for cosmetic use in the U.S. (Silikon-1000 is approved for retinal tamponade), but is legally used off-label. Artefill is FDA approved for cosmetic use (in the nasolabial folds), but it often used off-label for correcting minor asymmetries of the nose, too. These are the only permanent products available in the U.S. 

Again, however, with a non-living implant in the nose, I'd probably recommend my patients stay away from injecting a filler.

All the best,

--DCP

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