After surgery on tip of nose, a cartilage graft I had prior slipped out of place from the top bridge. It created a bump after it healed. My doctor injected Radiesse to camouflage the bump. He over injected on one side of my nose but forgot to inject under the implant. Should I have more Radiesse injected in the depression or should have the implant removed and after the Radiesse is gone I can have Artefill injected where the cartilage graft was originally? Been 2 months Radiesse was injected.
Slipped Cartilage Graft and Radiesse Problem
Doctor Answers (8)
Radiesse injection in the nose is a long term filler
Radiesse injection in the nose is a long term filler. Radiesse may take years to go away. Often what would be easier or less permanent is a hyaluronic filler. You may want to choose a hyaluronic acid filler like Juvederm because you can dissolve it if you don’t like the results or if it moves in the wrong location. I often will use Juvederm before injecting Radiesse for this reason. I would generally stay away from injecting Artefill into the nose because it is permanent. Your nose shape will change as you get older and Artefill will not change. In this particular situation you might want to try a hyaluronic filler to see how that works for you. That’s probably the safest bet.
Radiesse as a nasal filler
You might be better off seeking consultation with a plastic or ENT facial plastic surgeon to have a revisional rhinoplasty, otherwise you will be chasing this problem year after year, and the slipped cartilage can continue to shift, or get infected, or extrude.
The use of fillers to correct defects and nasal shape is very powerful. It requires expertise with fillers and their characterestics. However fillers are NOT a sustitute for surgical correction.
It is unusual for an old catilage graft to move that much, but it can happen.
the Radiesse that was injected into the nose is too much, you need to give it time. and work with your doctor.
Radiesse can stay for years in certain locations, and correction can be very difficult. Give it time , do not do any other procedure in haste that cannot be reveresed.
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Time is Your Best Option
This sounds like a bad to worse story. There must be a few pieces missing because if the cartilage graft was from a previous surgery, there is no way for it to have slipped with a tip revision. The Radiesse is difficult if not impossible to remove at this point. More importantly, as the Radiesse will eventually (in 1-2 years) resorb on its own, another revision surgery or filler treatment will ensure that you have asymmetry in the future.
If you absolutely can't stand your nose, you could try a hyaluronic acid which has the advantage of being dissolvable but my personal thought is leave your nose alone. Let time settle things down.
Non surgical nose job
This is a difficult issue. Fillers can camouflage unfavorable rhinoplasty results or even out naturally occurring nasal contour issues. The benefit is that they are non invasive, and, when applied in the right setting, they can yield dramatic improvement. The down side is that fillers are expensive and temporary. If a lump or bump occurs with Radiesse, it can sometimes be massaged and minimized. ArteFill is less forgiving. If a lump or unfavorable placement occurs, it is much more difficult to address. A more permanent result obviously involves surgery; So this may be the way to go.
Nose Graft Displacement, Radiesse, and Revision Rhinoplasty
Best to consult with rhinoplasty surgeons in person for best answer to your problem. Good luck and be well.
Radiesse and cartilage implant
Looking at the pictures there is definate asymmetry. There are a few options, that you should discuss with your plastic surgeon/dermatologic surgeon : including removing the graft and replacing, waiting till the radiesse wears off and then addressing with a longer acting filler, and filling to make everything symmetric.
Injectable fillers not the best solution to a cartilage-based contour problem in the nose
Since injectable fillers are temporary, their use to treat a permanent nasal asymmetry due to a cartilage-based problem (graft or otherwise) may not be the best solution. While inbjectable fillers create an immediate change and are easy to do, they can have their own complications as well. Certainly injecting fillers underneath a graft area, or trying to do so, is probably not going to work nor should be attempted. If you must use injectable fillers, use them as additions on top of existing nasal carrtilage structures.