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Can Nose Fillers Be Used to Augment the Nose Bridge Before Surgical Rhinoplasty?

I plan on getting surgical rhinoplasty just to correct my slightly deviated septum. I also want to augment the nose bridge through Radiesse (don't want to use an implant or autologous materials). I know that you have to wait months after getting a nose job before getting nose fillers, but I don't want to wait that long, so would it be safe to get Radiesse injected a few weeks before surgery?

Doctor Answers (16)

Rhinoplasty vs. Nonsurgical Rhinoplasty

+2

Thanks for the question... Just to make sure I understand your question, if you are having a deviated septum corrected, that would be considered a septoplasty, unless your surgeon is also reshaping the outside of the nose (rhinoplasty). Double check with your surgeon to make sure you are on the same page. If you are truly having just a septoplasty, I see no issues with having Radiesse placed in the nose (nonsurgical rhinoplasty) before or after surgery. Again, I highly recommend that you discuss this filler procedure in detail with your surgeon. 

However, if a rhinoplasty is planned, I would not recommend having Radiesse placed in your nose a few weeks before. Radiesse is a commonly used filler for nonsurgical rhinoplasty but it has the effect of creating some sticky adhesions within the surgical planes, making the surgery a bit more challenging. Radiesse cannot be reversed though it does eventually dissolve on its own. In some cases, patients will have Restylane, Perlane, or Juvederm injected in the nose months before and then dissolved with hyaluronidase prior to rhinoplasty. But performing a rhinoplasty while the filler is still present is not ideal, as this can make it difficult to determine whether the shape of the nose is due to the filler or the underlying bone/cartilage. If you decide to have filler placed in your nose after surgery, I typically recommend waiting for several months. 

Lastly, my preference for augmenting the bridge is to use your own cartilage, usually from the septum but sometimes from the ear or rib if the septal cartilage is insufficient. This augmentation is safe, predictable, permanent and offers the best outcome. You should also discuss all of these options with your doctor.

Best regards,

Dr. Mehta


Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Using Fillers Prior to Rhinoplasty not a great idea

+1

I would refrain from using fillers prior to your rhinoplasty. In addition, I am not a fan of Radiesse in the nose. There are well documented complications with fillers in the nose if not done by someone who is familiar with the anatomy. At least with HA's (e.g. restylane), there is reversibility of the product.

As for augmenting the nasal bridge, why not use autologous materials at the same time of your rhinoplasty? If done correctly, it can be a permanent, living solution in the nose and would obviate the need for repeated injections to that area.

Michael Kim, MD

Michael M. Kim, MD
Portland Facial Plastic Surgeon
5.0 out of 5 stars 19 reviews

Septorhinoplasty and Fillers

+1

Thank you for sharing. It is important to clarify what surgical procedure you are having performed. A septoplasty is a procedure to improve breathing by correcting deviations within the septum. The external appearance should not be altered. Alternatively, a rhinoplasty is performed to improve the external contours. These are often performed in concert, but this should be clarified prior to any surgical intervention. Filler can be used safely in the nose, but autologous cartilage is a far better and permanent solution. I would highly recommend using the septal cartilage to augment the dorsum if you have cosmetic desires. I hope this helps. 

Robert Brobst, MD
Dallas Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

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Fillers to Augment Bridge Before Rhinoplasty

+1

If you are going to have a rhinoplasy and septoplasty to correct your deviated septum your surgeon can and probably will remove cartilage from the septum which can be placed on your bridge to achieve permanent augmentation. There is no need for a temporary filler.

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

Injecting fillers into nose before nasal surgery is not recommended

+1

A rhinoplasty is not performed for a deviated septum.  A septoplasty is performed for a deviated septum.  This is typically billed to the patient’s medical insurance out of medical necessity due to decreased breathing capacity out of the nose.  Injecting fillers into the nasal bridge is just not a good idea. 

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

It may be best to have your nasal injections after your septoplasty, not before.

+1

It seems like you're having your deviated nasal septum corrected for nasal obstruction, and you wish to raise the height of your nasal bridge with an injectable filler treatment. Since you do not want surgical correction of your low bridge, it may be best to have your surgery first, and then proceed with the injectable filler procedure after that. My concern is the potential for introducing infection into the injected Radiesse, during your septoplasty.

Hope this helps you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 269 reviews

Fillers may be used with rhinoplasty surgery to improve results

+1

If you are having a rhinoplasty, a good idea would be to have your surgeon use your own cartilage to augment your bridge to the best of his ability, then you can always add fillers after the surgery to "tweak" the results.

I actually find non-surgical rhinoplasty with fillers to be a little more precise than with surgery, as your physician is able to "paint" the fillers exactly where desired.

Take a look at the attached video and you'll get and idea on how fillers can be used after surgery to make a good rhinoplasty result perfect.

Good luck in your search for information!

David Mabrie, MD
Bay Area Facial Plastic Surgeon
4.5 out of 5 stars 54 reviews

Can Nose Fillers Be Used to Augment the Nose Bridge Before Surgical Rhinoplasty?

+1

 No, most likely not.  The Radiesse or any filler placed to augment the nasal bridge would be encountered during the Rhinoplasty which dissects the nasal tissues off of the nasal skeleton.   Makes more sense to wait 6 months after the Rhinoplasty and have the dorsum augmented with Radiesse at that point.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Fillers are best for lines & folds, but not the nose.

+1

Since you are having a rhinoplasty, your surgeon should correct the bridge of your nose with surgery, not fillers. Fillers are temporary, so your result won't last.  Also, there are reports of having to "dig" old fillers out of the nose if they cause a prolonged inflammatory response or (worse yet) an infection.  Moreover, the result with fillers in the nose tends to be less exact, and the correction is not as precise as with rhinoplasty (there is more guess work with injectables).

Therefore, my advice would be to have your surgeon use the Radiesse for a subtle cheekbone enhancement (or for your nasolabial folds) while you are asleep during your rhinoplasty, and have the nose corrected with surgery, not filler. Best of luck!     

Randolph Capone, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Nose fillers and septal work

+1

If you want nasal augmentation , you are probably better off using something more permanent like cartilage.  If you do not want that and are having a septal procedure, you should what a few months until things have healed. I would not do it before surgery.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 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.