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Is It Necessary to Remove Perlane on Nose Before Nose Job?

I had 0.5ml Perlane injected to my nose bridge in December. I am considering a nose job, and I've consulted with many doctors.

Some of them said I don't need to remove the 0.5ml Perlane due to the small amount. Is this true?

Doctor Answers (15)

Filler in nose should be dissolved before rhinoplasty

+1

It is best to wait the Perlane to dissolve, which takes roughly a years’ time. Unfortunately the filler cannot be removed like an implant. There have been disastrous consequences from these types of injections placed in the nose, which is why it is not advisable to do so. You need to wait at least a year to know what your true nasal anatomy is prior to undergoing a rhinoplasty.


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

Rhinoplasty after Perlane Injection

+1

It would be best to wait until after the Perlane dissolves. However, if you decide to do the nasal surgery in the near future, review pictures taken before the filler injections and make sure your surgeon is aware of the Perlane procedure. There is a slight risk that a minor surgical revision will be necessary after the Perlane does dissolve.

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

Perlane removal before nasal surgery

+1

Any substance that alters the contour of your nose should, if possible, be gone before operating on the nose to improve the appearance. Perlane will most likely absorb and disappear within the next 6 months or so. When in doubt, it is best to wait.

Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon

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Surgery after Perlane

+1

Contrary to what some physicians think, I think it is imperative to wait until your Perlane is all gone. By waiting to see what your nose actually looks like you can actually make a better decision as to what you want your nose to look like. Its a more accurate way to get the results you want.

Carlos Wolf, MD
Miami Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Rhinoplasty Surgery may be safely performed after an Injectable Filler treatment to your nose.

+1

It sounds like you did not have too much filler injected in your nose, and Perlane is not a permanent filler. I have personally performed Rhinoplasty Surgery on patients with previous Filler treatments without any issues.

What are your goals with surgery? If you're looking for permanent augmentation of your nasal bridge, then you may consider a Non-Surgical Rhinoplasty from a physician experienced in the proper application of Silikon-1000. This is a permanent filler that works particularly well in your nasal bridge.

I've attached photos for your perusal.

I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 276 reviews

Dissolve the filler before the rhinoplasty

+1

0.5 cc of any dermal filler is actually a fairly decent amount when used on the bridge of the nose. In fact, it would be uncommon to use much more than that to fill in a low radix or a small contour irregularity. When I use dermal fillers in the nasal dorsum, 0.3 cc to 0.8 cc is typical. I'm surprised that my colleagues would think your volume is so small.

But to answer the question, yes, it should be completely gone before a surgical rhinoplasty. The best way would be to inject a small amount of hyaluronidase (an enzyme that dissolves hyaluronic acid gels such as Perlane, Restylane, and Juvederm). The injection should be done a week or two before the rhinoplasty. Even thought the hyaluronidase works quite quickly, it's best if there isn't even a trace of needle trauma at the time of surgery.

All the best,

--DCP

P.S. in the link below, this patient had total of 0.8cc of Radiesse, which included augmenting the radix (the root of the nose) and the supratip depression, as well as some smaller wrinkles around the mouth (not shown in the lateral view) just to use up the leftover volume in the syringe. [The nose alone received 0.5cc of the 0.8cc]

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

Removing Perlane on nose before Nose job

+1

As you can see the consensus from all the expert posters is why wait? That very small amount of Perlane injected will not effect the rhinoplasty surgery. Again 'why wait'?

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

Remove Perlane before a rhinoplasty (nose job)

+1

The injection you had of Perlane in the nasal bridge was probably used to hide a bump of the bony nasal profile by filling in the depression between the hump/bump and the area between the eyebrows. This makes a straighter line and the bump no longer seems as obvious. The plastic surgeon will be operating to probably file down the bump in the nose and will use their feel to check the results. Ultimately you may have a great result, but when the bony profile is made flat with the surgery, you may find that the 0.5 cc of Perlane now makes a bump itself because the adjacent area is now flat. If that is the case, hyaluronidase can be injected at that time, after surgery. If there is a chance that the nasal bones have to be fractured during the rhinoplasty, then ask the plastic surgeon who is operating on you if the residual Perlane could interfere with the healing in any way. Good luck.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

Injectable fillers prior to rhinoplasty

+1

Even small amounts of fillers can have a significant effect on your rhinoplasty as the surgical judgement and techniques used should be planned out based upon your appearance prior to the rhinoplasty and your desired final outcome. That being said, it is very easy to dissolve out the perlane if you want to proceed with the rhinoplasty. Small amounts of hyaluronidase will dissolve it out giving your physician a more accurate assessment of your nose. I hope this information helps. Also, .5cc is about 1/2 vial of perlane which is in my opinion a significant amount.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Rhinoplasty after fillers.

+1

 The amount is so small it should not affect the final outcome. If you inform the surgeon he will take this into consideration in doing the nose.

Toby Mayer, MD
Beverly Hills 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.