Which procedure would help minimize the appearance of redness on the nose 6 years after collagen injections? (photos)

Question

I had a “collagen” injected on my nose 6 years ago, she wasn’t a licensed cosmetologist n definitely not a doctor. weeks after procedure I began to notice my nose beginning to shrink but it turned out extremely red.

Carlos Alberto Ríos García, MD · Answer

I understand your concern. Persistent redness and tissue changes years after an unlicensed filler injection should be evaluated very carefully, especially in the nose where the skin and blood supply are delicate.
One important thing to understand is that many patients are told they received “collagen” or another temporary filler, but in some cases the actual material injected may have been something entirely different, including silicone or other permanent substances. The fact that your nose began changing shape and developing progressive redness relatively soon afterward raises concern for possible chronic inflammatory changes, vascular compromise, scar tissue formation, or reaction to permanent material.
Based on the photos, this does not appear to be simple temporary irritation alone. However, without examination, imaging, and sometimes tissue evaluation, it is not possible to determine whether the redness is related to chronic inflammation, thinning of the skin, vascular changes, scar tissue, residual filler material, or a combination of factors.
Treatment depends heavily on identifying the underlying cause first. In some patients, vascular lasers or redness-targeting treatments may help reduce superficial redness, but if there is ongoing inflammation or permanent filler within the tissues, treating only the surface may not fully address the problem.
The nose is one of the most delicate areas for revision procedures because aggressive treatment can potentially affect circulation, skin viability, contour, or structural support. Cases like this often require a very careful reconstructive approach focused on preserving the integrity of the nasal tissues while determining what is realistically reversible and what must be managed conservatively.

Raffy Karamanoukian, MD, FACS · Answer

Silicone biopolymers are commonly used in the face and body. They may sometimes cause noticeable symptoms that we gauge using the Karamanoukian Soft Tissue Reaction Grading Scale from I to V. The severity of your complications dictates the interventions needed, ranging from itching and burning to severe necrosis of the soft tissue. Nerve pain and symptomatic swelling is also possible. Insurance may cover your surgery, but that is a discussion that requires you to contact and appeal to your insurance carrier. Options for removal are complex and depend on whether you have the material in your face or body. We reverse BBL with silicone commonly and remove silicone from the lips very commonly. Diffuse silicone in the face is not likely to respond to removal. Filler migration, swelling, and granulomas can cause significant discomfort and cosmetic ramifications. Our office specializes in the use of enzymes and filler reversal techniques without hyaluronidase to help improve the results of botched cosmetic fillers, whether caused by Juvederm, Restylane, or foreign fillers. We can also test for the material to determine the likelihood of silicone granulomas and silicone reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

J. Timothy Katzen, MD, FACS · Answer

Hi Intellectual454923, Thank you for your question regarding which procedure would help minimize the appearance of redness on the nose six years after collagen injections. It appears from your pictures that you are suffering from an inflammatory response (redness and swelling) to the substance that was injected into your nose. It is highly unlikely that your “licensed cosmetologist” injected collagen. Collagen would have been absorbed within 12 to 18 months. It appears from your pictures that you have a different product injected. If you were injected in North America, it is probably most likely silicone. Steroid injections will only mask the problem associated with silicone injections into the nose. Steroid injections decrease the inflammatory response but do not remove the offending injectable. In addition, antibiotics do not help because they do not remove the product from your nose. The only way to permanently get rid of an inflammatory response is to remove the offending product. Therefore, I would suggest the removal of the injections. Most plastic surgeons would approach the silicone removal through a rhinoplasty incision. During the surgery, an incision is made across the columella, and the dorsum of the nose is exposed. The injected silicone and scar tissue are removed from the cartilage, thin septal space, and deep dermal layer of the nose. Strict care must be taken to avoid damaging the nasal skin. The procedure is performed under general anesthesia and would take approximately three hours to complete. Plan on a recovery of approximately 7 to 10 days. You will have some residual swelling, but the swelling should be gone after approximately eight weeks. Good luck. I hope I have answered your question regarding which procedure would help minimize the appearance of redness on the nose six years after collagen injections.

Which procedure would help minimize the appearance of redness on the nose 6 years after collagen injections? (photos)

Answers (3)

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