Revision - Closed columnellaplasty and filler to raise the bridge? (photo)

Hello and thank you for your question. Based on your photographs, You are a great candidate for a revision rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

I do believe you may benefit from a repair of your hanging columella, and at the same time, it seems as though your lower bridge may be projecting a bit too far from your face. In our practice, repairs like this would be best approached with an external incision. I hope this helps, and thank you so much for your question. Sincerely, Dr Joseph

When considering revision rhinoplasty, it’s completely natural to arrive with preferences or ideas in mind—like combining filler with a surgical touch-up. But in practice, the best results aren’t built from mixing modalities; they come from selecting the most stable, predictable path to your goals.
Filler may seem like a simple enhancement, but it introduces unpredictability. Even in expert hands, it can migrate, be absorbed unevenly, or compress the cartilage beneath it. Over time, this can create new issues that weren’t there before—ones that ultimately require surgical correction. In rare cases, filler complications can become serious, from skin necrosis to vascular compromise or allergic reactions. These risks are avoidable, especially when a controlled surgical environment offers more reliable outcomes.
Surgery, on the other hand, gives a surgeon the ability to refine, support, and structure with precision. A revision rhinoplasty—even a focused one like a closed columellaplasty—should be approached with full clarity about the anatomy, past interventions, and the aesthetic goals you want to reach. That’s why most experienced revision surgeons prefer to lead with a holistic plan, not one limited by materials already placed or by techniques chosen in advance.