Bossae coming back after revision rhinoplasty, are fillers the solution? (Photos)

Question

I had my first rhinoplasty on 2015 which left me with a tip bossae on right side which made my nose look deviated. I went under a revision 7 weeks ago. I was happy with the results until last week when the bossae started reoccurring. Can the scar tissue under my skin be pulling my cartilages and creating the bossae? Can fillers fix this? Is it ok to repeat doing fillers yearly for the rest of my life? Can a revision be done under local anesthesia by putting an ear graft on the bossae?

Tanveer Janjua, MD · Answer

Nasal tip bossae can be easily shaved off or morselized under local anesthesia in the office. This would avoid the need for repeated fillers. Regards

Eric M. Joseph, MD · Answer

Seven weeks postoperative may be too to consider any interventions, surgical or Nonsurgical since your nasal tip is swollen and healing. If nasal tip asymmetry, or visible tip cartilage persists, microdroplet Silikon-1000 treatments may be considered for camouflage or volume replacement, depending on your examination. Hope this helps!  Dr Joseph

Jeffrey Marvel, MD · Answer

My personal opinion is that this is a good case for a filler.  It will not be that easy of a procedure to harvest ear cartilage and place in the defect without another trip to the OR.  That is to say you will need IV anesthesia and for all practical purposes an office based surgery room.  In my practice I have found the off-label use Bellafill (which is a permanent filler) judiciously injected into defects like that can be preferable to another surgical procedure.  You may want to give that serious consideration.  There could be some serious downsides to opening up the nose again, such as alar retraction.  I have not had any complications from the use of Bellafill over the past few years.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,Sorry to hear about your bossae. I dont think that injectible fillers are the answer for the tip. You can have a revision tip-plasty under local anasthesia with mild sedation. The sedation releive your anxiety, decrease your blood pressure and your heart rate and ultimately decrease bleeding and bruising post-op. This can be done even if you need ear cartilage grafts.Best,Dr.S.

Bossae coming back after revision rhinoplasty, are fillers the solution? (Photos)

Answers (4)

Answer: Tip Bossae and Revision Rhinoplasty

Answer: Tip Bossae and Revision Rhinoplasty

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Bossae coming back after revision rhinoplasty, are fillers the solution? (Photos)

Answers (4)

Answer: Tip Bossae and Revision Rhinoplasty

Answer: Tip Bossae and Revision Rhinoplasty

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.