Will injectables make a secondary rhinoplasty more difficult?

I had a silicone implant to augment my flat asian nose. But the implant looks very unnatural and I want it removed. I haven't decided what's the best look for my nose, however. I'm thinking about having the implant removed and try an injectable such as Juvederm or Radiesse, before having a secondary Rhinoplasty to permanently change my nose shape again.

Will Juvederm or Radiesse injections make the second nose surgery more difficult?

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See related question: Non surgical nose job before rhinoplasty?
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9 answers to “Will injectables make a secondary...”

A: Cosmetic injectable to the nose will make rhinoplasty more difficult to perform

William Portuese, MD

The silicone implant can definitely be removed and resized to a smaller, more aesthetically pleasing implant. It is not a good idea to have Juvederm or Radiesse injections into the nose, which will make any further rhinoplasty much more difficult to perform. There are many different sizes and shapes of the... more

A: Rhinoplasty Revisions with filler injections

Daniel Reichner, MD

In general, I would advise against filler injections in your case. If you decide to use a filler, hyaluronic acid is the safest, but the amount of correction is limited. It is important that your surgeon is comfortable with morphing, which I believe is an essential tool... more

A: Fillers, Juvederm can reduce need for revision rhinoplasty

Peter E. Johnson, MD

Nose_obsession, Fillers such as Juvederm and longer acting Radiesse have been helpful in softening small imperfections in the nose, both in the tip and the bridge of the nose after rhinoplasty. They can help with the decision as to whether a revision is worth the effort as patients can see the anticipated... more

A: Any change in the tissue will make the surgery more difficult.

David Shafer, MD

Any modification to the tissue on the nose will make surgery more difficult. In rhinoplasty, most of the surgery is changing the underlying structure and re-draping of the overlying skin. If you have changed the character of the skin, then it makes the surgery more difficult and may effect the results. Good... more

A: Consider more permanent nasal implant

Michael A. Marschall, MD

Hi! I am not certain the filler option will provide the best look for dorsal under projection.  Indeed, all are temporary in a relative sense, and further procedures may be necessary. Consider perhaps placement of a graft, bone, cartilage as a more permanent solution.  This can be undertaken using... more

A: Non-surgical Rhinoplasty with Radiesse not advisable

Stella Desyatnikova, MD

Radiesse can make subsequent nasal surgery very difficult. If you decide to go the injectable route, I would recommend Restylane. Juvederm is very good as well, but Restylane might provide slightly more support and structure for the desired nasal shape. Both of these are hyaluronic acid, and will dissolve over... more

A: FIllers on nose not a good choice

Toby G. Mayer, MD

The fillers that you mention will be gone in 12-18 months and will not affect a rhinoplasty later. However, I think you will be wasting money in that Asian noses usually require a great deal more augmentation than can be achieved with fillers. Cartilage and soft tissue grafts will give you the result you want... more

A: Radiesse on nose can make Rhinoplasty difficult

Peyman Solieman, MD

Dear Nose Obsession, This is a great question that we get in our practice a fair bit and that we have looked into. In fact, we in association with our colleagues reviewed the largest series of injectible rhinoplasties done by anyone to date. I don’t want to make this a long diatribe about the merits of... more

A: Be careful with fillers in the nose

Jacob D. Steiger, MD

Rhinoplasty after filler injections such as Radiesse can result in increased difficulty with a Rhinoplasty procedure. In addition, I have seen several cases of complications with Radiesse in the nose (from other offices), and for this reason do not recommend it.  Restylane may be a safer product for the... more

Comments

A-J
1 post
3 Mar 2009

nose-obsession: don't! Fillers won't help you. Please go to a surgeon who can rebuild the bridge and don't opt for K-mart surgery. Hollywood is filled with monstrosities from bad surgery, and experimental medicine. Even 10 years ago who ever saw so many cases of bad surgery as we do today? I had very bad results from a rhinoplasty with Dr Robert Kotler (Beverly Hills, CA) using an implant. After all the swelling went down the results look awful. The doctor did corrections with fillers. Did nothing at all but turn the area red for months. I have an ugly dent all across the bridge from the implant which turns red and don't cover up with makeup. It shows clearly. The bridge and tip is too wide (wider than before surgery), and I have a wide band across my nose marking the location of the implant. This visible dent and line across the bridge is what the doctor wants to solve with fillers. But how will fillers solve the wide bridge or tip?.. Unhappy with a broken looking nose and hearing comments about it, I consulted several surgeons including a senior surgeon, top in his specialty. He almost had a fit hearing about fillers being used on me to solve bad surgery. He does revisions on 1000's of bad filler work. The senior surgeon explained that fillers often cause skin and tissue damage even years later, that is then difficult to correct. He consider it a complete no-no with rhinoplasty. Its simply shoddy work, - the Kmart of plastic surgery - instead of doing a proper surgical procedure and build up the bridge that give good permanent results. I find it completely unacceptable for a surgeon to not make all necessary efforts to correct the errors made, even if they have to pay for a revision. Its their own mistake and they need to be responsible. I have tried and tried to communicate with the doctor for months, which seems a waste. The doctor is at least responding (he is a nice man). But he is stubborn to his own views and wont cover costs for a revision. He insist on fillers but the problems go beyond fillers. I want a proper revision. I also don't want revision by the same doctor (naturally). I guess diplomacy in these matters never work, and I will have to resort to a lawsuit. I'd prefer not to, as he's a nice man, and I have seen excellent work of his from chemical peels, but my surgery results are dreadful. The work looks cheap. People around me ask if I have been in some accident and had my nose broken.

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