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Can Fillers or a Revision Reshape my Nose Bridge?

A month ago, I had a Rhinoplasty. The doctor unfortunately lowered the bridge too low, and my nostrils look uneven and smaller then usual. I specifically asked him not to change my side view, but to only make my nose a bit narrower from the bottom. Should that really affect the shape of my nostrils? Also, should I consider fillers to reshape the bridge? Or should I have a revision done? Most importantly, if I give a doctor my old pics, can he/she bring back my nose shape the way it was?

Doctor Answers (10)

Not a good idea, if someone is contemplating revisional surgery

+1

It is better to wait approximately one year and then consider undergoing a revision nasal surgery using the patient’s own cartilage to re-build up the bridge back to its normal anatomical state. Injections into the nose are not a good idea, especially if someone is contemplating undergoing revisional surgery.


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Fillers give a temporary benefit

+1

Reshaping of the nostrils can only be accomplished by resecting a portion of the nostrils (wedge resection), narrowing the base of the collumela between the nostrils,or adding a cartilage graft to the alar rim. The choice depends on what the initial problem is.

Using a dermal filler in the nasal dorsum will give you an idea of how an augmentation of the dorsum would look , but fillers are only temporary. You will probably need some sort of revision. Discuss the problems that you see with your physician and don't hesitate to seek a second opinion and if you're not happy with the treatment of choice proposed by your physician

Joseph M. Perlman, MD
Houston Plastic Surgeon
5.0 out of 5 stars 8 reviews

It's a little early right now for Rhinoplasty revision

+1

It's still early so you might want to wait a few months. I know this is hard, but a lot of times what you are looking at is swelling that is affecting the way it looks. Swelling can make a big difference.

Fillers for the bridge is a temporary solution that can cause problems. Radiesse is often the most considered for that region of the bridge but there are reports of complications with it there as well. Dr Toriumi, I believe has an article on that.

A rhinoplasty revision might be the best choice for you for your nasal bridge issue. If it is truly short, you might need some grafting material. Ear cartilage and septal cartilage can be used if it is a little deficient. But if you are looking for a big change like 3-4 mm of additional height you will need either a rib cartilage graft or silicone. Goretex is another option in this area.

The nostrils can definitely be different if things were not made even during the surgery. The open technique is the most accurate means and your incision under your nose is very minimal. And, yes definitely you can bring pictures of yourself and your surgeon can help make it look a little more like what you had before. You'll get the feeling of the right person to help you with this. You have to find someone that cares and will help you through this process every step of the way.

Philip Young, MD
Bellevue Facial Plastic Surgeon
3.5 out of 5 stars 29 reviews

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Get other opionions about your secondary rhiinoplasty

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Clearly this rquires a consultation and physical exam to determine the extent of surgery required.

Fillers may provide you with some improvement but it would only temporary and may interfere with subsequent corrective procedures.

Seek second opinions from other physicians as to your options.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 41 reviews

Give Rhinoplasty more time

+1

It will take many months for swelling from a rhinoplasty to resolve to guage your result. I tell my patients up to 1 year. It is virtually impossible to change one aspect of the nose without affecting another part. For example, narrowing the tip slightly will almost always slightly change the shape of your nostrils.

Unfortunately if you notice that the bridge or dorsum is already too low, this is unlikely to change. You are correct that a filler could be placed or you could have a revision procedure, but I would wait a minimum of 6 months before proceeding. In general I discourage fillers especially in thin skinned patients where irregularities and other complications have been reported. I wish you the best of luck.

Samson Lee, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Good suggestions

+1

These are all good suggestions. The nose can really hold onto swelling for many months after a rhinoplasty procedure. This can make the nostril misshapen or even give the appearance of a low dorsum if the tip is a bit swollen.

It is too soon to consider filler injections to the nose. I also don't recommend this as a treatment option even if the dorsum was taken down too much. There are better ways to permanently correct this problem. Keep in touch with your surgeon. Follow up regularly and let us know how things turned out!

Henry Daniel Sandel IV, MD
Annapolis Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Fillers are a temporary fix in Rhinoplasty

+1

I don't have a problem using small amounts of fillers, especially Resytlane and Juvederm to temporarily correct small defects. You can have them removed with a small injection of hyaluronidase if and when you are ready for your revision. In the end, however a revision will probably be necessary if the bridge is significantly lowered.

Corey S. Maas, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

Rhinoplasty Revision ; Too Much Profile Removed

+1

Hi Anon,

I am sorry that you did not get what you desired from your initial rhinoplasty one month ago.

You have about 5 more months until a revision rhinoplasty should be considered. In the meantime you speak with your rhinoplasty surgeon and even interview other rhinoplasty specialists.

I would not recommend having any fillers placed at this time. Fillers would make it very difficult to evaluate your nose for the revision surgery. If you decide that you are unable to have revision rhinoplasty for the next few years, then you may have filler augmentation.

Choose your rhinoplasty surgeon most carefully.

Good luck and be well.

Dr. P

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

Unfortunately, it is too early after Rhinoplasty to tell

+1

You will have to wait until the swelling in your nose is gone before you make any decisions about what needs to be restored. I wouldn't recommend any injections of any kind until the nose has finished healing.

It is important to work with your surgeon during the healing process to make sure you and he/she are doing all that you can to improve the situation and avoid making things worse. After about one year, you can look into your revisional needs more effectively.

Use of injectible filler like a hyaluronic acid (eg. Restylane, Juvederm, etc.) or Radiesse is possible but temporary, and has its own share of problems. There are more permanent ways to improve the height of your bridge, etc. but will require surgical intervention. I always recommend finding a surgeon with experience in revision rhinoplasty to consult with about your options. Finally, if you don't seem to see eye to eye with your surgeon, then it is in your best interest to seek a second opinion.

Unfortunately, bringing things back to the way they were is essentially not possible because of the other changes made to your nose in the narrowing process. But I wouldn't fret if you have realistic expectations. You need to evaluate your expectations from the inside before going and requesting changes on the outside if a revision rhinoplasty is something you feel will be necessary. Surgery will only be more difficult.

Good luck.

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
5.0 out of 5 stars 19 reviews

Difficult situation here.

+1

I would recommend constant contact with your doctor.  Swelling will take upto two years to subside. Fillers will only be temporary, but at least may make you feel better.  It will be very difficult to make things the way they were.

sek

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 45 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.