My Nose Looks Larger After Dermal Filler of Nasolabial Folds

Rather than attribute this to an optical illusion, I believe that your interpretation of your before and after pictures warrants careful consideration and examination. Facial surgery or facial fillers can dramatically affect facial harmony and the relative proportion of one area with respect to another. Your assessment of the changes on your face are an exact representation of these changes, rather than an 'illusion.' My advice would be for you to carefully review your before and after... more

On the one hand, deep injections of the nasolabial folds may lift the nose away from the face by adding bulk beneath the nostrils thereby lifting the nose off of the facial skeleton and providing additional projection to the nasal tip. In some instances this is desireable and prevents or corrects a drooping nasal tip that is seen with and aged face. In regards to the nasal bridge, I am very puzzled by this because it is very far from the injection site and makes no immediate sense. I can... more

Karen, You have an unusual concern. Without seeing pictures, it is hard to tell for sure. Also, if you are using a pocket camera for the post-injection pictures, then these tend to make the nose look larger because of the angle of the optics with a small lens. For pictures of the face, it is best to use an SLR camera, which will give much less distortion. As for the fillers, there are injections which you can have to decrease the Juvederm and the Restylane. There really is not much you... more

Hi Karen. What you have certainly can be an optical illusion. It is very common for patients to notice an area next to a treated area and state that there has been a change to the UN-treated area. This happens all the time in liposuction, tummy-tucks, body lifts, etc. The same is true with dermal filler injections. HOWEVER, as Dr Desyatnikova has pointed out, it is possible to overinject fillers in the nasolabial nose and "change" the way the nose looks. Many practitioners inject the... more

I would actually venture to say that it is possible that an indiscriminate use of filler can indeed make your nose look bigger and wider in the lower portion and in the middle. Using too much filler at the top portion of the nasolabial folds can lead to its accumulation there over time. It can also push and distort the surrounding tissues, including the natural "valley" between your nose and your cheek, and create the unpleasant "overfilled" look. I would recommend that you consult a... more

Greetings Karen, What you are describing sounds like an opitcal illusion though without seeing it in person I can't say for sure. There is some local swelling when a filler is injected and in fact hyaluronic acid fillers such as Restylane and Juvederm work partly by having an increase in swelling. It would be unusual to get swelling on the top of the nose when the nasolabial folds were treated though. I would agree with Dr. Freund, it may be wise to hold off getting any more fillers for... more

This is an unusual thing you are describing and I have never heard anything like it from a patient or at a national meeting. Since all of the injectables you have used are temporary, it is probably best to avoid any more treatments for quite some time and wait for changes to resolve.

Karen, At the risk of cliche, I must first assume that you have had your injections performed by a board certified plastic surgeon or dermatologist. If not, it is conceivable that your injecting physician may be placing the product in the incorrect location. This would explain a widening of your nose. If the product is injected too deeply, it could also conceivably migrate up to the nose. The effects of swelling may also be contributing to the distortion. At any rate, the hyaluronic... more

Hi Kareni, I have never had a patient who experienced your complaint with dermal fillers in nasolabial folds. I have seen swelling at the bridge of the nose with ill advised injections for the horizontal lines at the top of the nose. It is difficult to answer your question without seeing photos and knowing where and how much of the product was placed. If this continues to trouble you, see a rhinoplasty specialist. Steven Pearlman, MD, and Norman Pastorek, MD are excellent nasal surgeons... more

Facial fillers are known to cause local tissue swelling. This is a reuslt of the product absorbing water during its degradation( breakdown).  However, it is highly unlikely that you are experiencing reactions to these products in areas where you were not injected with them. 

Dear Karen, What you describe sounds most definitely like an optical illusion. Each part of the face relates to the areas around it. For example, if you have big cheeks, then your nose appears smaller. If you have a small or retruding chin, the your nose looks bigger or projecting. In your case, the nasolabial folds you describe create an heavy, dark frame that outlines the width of your nose. When you took the folds away (by filler) the frame for the nose is now gone and the nose appears... more