I need to have a dent above my tip filled in after a revision rhinoplasty. Can I have temporary filler put in for the year I will have to wait before a more permanent solution, like filling in the space with soft tissue or cartilage? Will the filler disolve enough in time? Is this a good idea?
Filler Now, Small Revision Rhinoplasty Later for Nose Dent?
Doctor Answers (29)
Filler for small nasal defects
The filler option is fine, as long as you are about a month or more post revision. If you try to use it too quickly after a surgery, the results are less predictable. The choice of product like restylane, juvederm, or radiesse is not that critical, but if you are looking only for a year effect, stick with restylane or juvederm.
Some long term studies have shown that restylane (and therefore very likely juvederm) induces collagen deposition of your own during healing. So it is possible that you can get more lasting results with only using filler if you wanted to avoid a third surgery. However a couple of injections in series would be required. Just an option. The fillers are very precise, safe and natural.
Fillers as temporary solution while waiting for revision rhinoplasty
There are several important considerations when using soft tissue fillers in the nose to improve safety and prevent both short and long term complications. Use temporary fillers NOT permanent (Silicone, Artecol). Use gel fillers NOT particulate (Radiesse, Sculptra). The amount of filler injected at one time must not be excessive as this can cause problems with not only the appearance but also the blood supply. Hyaluronic acid fillers are ideal for injection into the nose as they are temporary (usually last for over 1 year) and gel. Additionally, if too much filler is injected or there are problems with blood flow to the nose, an enzyme (hyaluronidase) can be injected to dissolve the product and reduce the risk of skin loss and scarring. Both Juvederm and Restylane are commonly used hyaluronic acid fillers. Another consideration is that you have had previous surgery which causes the skin to be less pliable, so injecting fillers can be more challenging.
You would benefit from seeing a board certified plastic surgeon that performs both revision rhinoplasty and soft tissue filler injections into the nose to see what would be an appropriate option for you.
revision rhinoplasty or filler to fix a small dent
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Fillers and Nasal Revision Surgery
The current role of hyaluronic acid fillers that are non-particulate fillers such as hyaluronic acid fillers like Juvederm or Restylane are good temporizing fillers to correct small nasal indentations that will allow one to wait and look good while you’re waiting for the nose to mature. One can then do a true revision rhinoplasty 12-15 months after the procedure if one is needed.
Juvederm or Restylane for temporary fix after Revision Rhinoplasty
Tissue filler before revision Rhinoplasty?
A tissue filler can be used as a temporary solution while waiting for further surgery. The filler should be resolved before commencing the Rhinoplasty.
Using fillers to correct small defects in rhinoplasty
It is possible to correct small defects or depressions in the bridge of the nose with a dermal filler after a rhinoplasty. This may be used as a bridging procedure before the patient receives a revision rhinoplasty a future date. In this area the face, a small amount of filler will go a very, very long way. For this reason it is essential that you only work with a board-certified plastic surgeon who has a great deal of experience in rhinoplasty and dermal fillers to obtain your best results. Such a surgeon will be able to make a mouth correction until you can receive your revision surgery.
Fillers a good idea while waiting for revision rhinoplasty
Injectable fillers are very effective for correcting small irregularities of the nose. I generally prefer waiting at least 12 months after a primary rhinoplasty before performing any revision surgery. A filler may be an effective way to optimize appearance while waiting to the appropriate time for revision.
Fillers can be an option for temporary improvement in contour defects
A filler such as Restylane can provide improvement in your appearance for approximately six months. Since it is all absorbed, this temporary improvement will not interfere in the ultimate surgical outcome of whatever revisionary nasal surgery you choose. I think your idea is a very good one.
Be careful with the tip
There are several different, safe and proven fillers available now for use in the face and nose. In general I feel much more comfortable using small amounts of filler to correct irregularities of the dorsum (the upper two thirds of the nose) rather than the tip.
The problem with the tip is that there are deep, large pores that are full of bacteria and there is a risk of infection or even possible injury to the skin. You need to make sure the doctor doing the filler understands this and injects deep, below the skin. That being said I prefer to use Radiesse right over the bone or cartilage in the dorsum. It can last for a long time. Hope this helps