Will Non Surgical Nose Job Hinder Future Rhinoplasty?

If you are considering having a Rhinoplasty in the future, I would hold off on fillers and/or fat injections in the nose. Fat has the blessing and the curse of lasting (the portion that stays and the portion that is absorbed is unpredictable) in the area injected. Radiesse is the most frequently used filler in the nose. It is a semi-permanent filler, lasting about a year. Its longevity is first related to volume effect from calcium hydroxylapatite and then later related to collagen deposition (scar tissue). In my experience, this factor adds a layer of avoidable complexity to a Rhinoplasty.

 I started doing fat grafting 30 years ago when other surgeons said it didn't work. It does work! It does last!  However, I never use it in the nose. If you want to try a filler use Radiesse which is reversible in time and then you can get your nose done properly.

Hello,
Both the good and bad news about using fat injections in the nose is that when the fat grafts take, they are permanent. Permanent fat in the nose may make your future rhinoplasty more difficult.
If you are not yet ready for rhinoplasty, I would recommend sticking with more temporary fillers in the nose if you must, such as Restylane, Juvederm, or Radiesse.
Good luck and be well.
Dr. P

First, it is *not* true that one must wait a year after using a hyaluronic acid gel filler (Restylane, Juvederm) before undergoing surgical rhinoplasty. But it is absolutely true that the filler must be completely gone. Fortunately, these fillers can be dissolved away quite well ahead of time with hyaluronidase.
The point is that the surgeon needs to see the nose without residual filler present in order to formulate a proper surgical plan. Certain fillers such as Radiesse cannot be forced to dissolve and must simply dissolve on its own, but this can take upwards of 1.5 to 2 years. Serial photos should be obtained to verify its dissolution.
Artefill, a permanent filler, is another issue entirely. I do use it in select cases of non-surgical rhinoplasty, but usually this is for patients who've had a previous surgical rhinoplasty and are either not candidates for revision, don't want a surgical revision, or for whom surgical intervention would be overkill (fixing a minor dent, for example). Since it is permanent, surgery after its implantation needs to be done with special considerations, but fortunately, its shape is generally stable (at least to the degree that surgery is stable) and can be compensated for in the surgical plan.
All the best,
--DCP

The increased popularity of injectable fillers, such as Restylane and Radiesse for treating facial wrinkles and for restoring volume to the face, has spilled over into nasal surgery. These substances are now being injected into the soft tissues of the nose to change its shape -- i.e, a non-surgical nose-job. The deformity of the nose will dictate how much of the injectable substance is required to achieve the desired result.
While injectable fillers may be appropriate for treating localized deformities, such as depressions or a low bridge, large volumes are required for an substantial change in nasal shape.
Most of the products that have been on the market for the last several years are temporary. However, newer, longer-lasting fillers have become available. Some of these are permanent. This poses a problem when the result does not meet the patient's expectations.
Many surgeons are begining to see patients who come to their practice for revision surgery because they are displeased with the results of injectable fillers. The large volumes of these substances are changing the way the natural tissues appear, which can make revision surgery more difficult, and in some cases, impossible.
Over time, these fillers have been noted to cause skin changes, such as redness, in some patients if they are injected too close to the surface of the skin. They may also give the nose a lumpy appearance.
The patient who is considering undergoing changing the shape of their nose, should visit with a qualified rhinoplasty specialist to determine whether or not they are a candidate for such procedures.