Post Open Rhinoplasty dents in nose, should I try filler or get a revision surgery? (Photo)

Question

I had my first Rhinoplasty about 7 months ago and I’m having a hard time accepting the healing of my nasal bone and how it looks. It’s like the nasal bone and cartilage belong to two different noses as there is not a smooth transition between them. There are a couple very noticeable dents. My doctor advised to wait the full year before doing anything and to try filler over another surgery. My wedding is coming up. Any advice?

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have several indentations where the bony portion of your nose meets the cartilaginous portion of your nose. Depending on your examination, microdroplet Silikon-1000 injections maybe considered fulfilling these indentations for a smoother and less operated nasal appearance. I hope this is helpful! Sincerely, Dr Joseph

Oakley Smith, MD, FRCSC · Answer

Hello,
Liquid rhinoplasty using filler can help in improving the shape of your nose and hide the irregularities/ dents on the bridge of your nose. It might be a better option for you as it gives immediate results.

Ronald J. Edelson, MD · Answer

Your bridge bones are  wide so it may need to be broken again. Fillers can bridge the time while waiting for a revision

Nelson Lee Novick, MD · Answer

A cohesive, low viscosity HA filler is a very reasonable route to go and would be my personal first choice were I in this situation. I would also have no personal qualms about treatment at this time, rather than waiting. It is imperative, however, that you seek treatment at the hands of a highly experienced physician injector, as the nose is a very vascular site where injections may rarely inadvertently lead to vascular compromise. Moreover, the vascular anatomy can be even more complex in a nose that has undergone prior surgical rhinoplasty. So, this is no place for novice injectors. Make sure to consult with an experienced, board certified cosmetic dermatologist and best of luck and congratulations on your upcoming wedding.

Inessa Fishman, MD · Answer

The posted photos suggest a separation between the bone and cartilage parts of the nose bridge; if this is the case, this is unlikely to get better with time.  If your wedding is within the next 6 months, fillers may be a better option, as they can provide an immediate improvement with little to no recovery.  Long-term, surgical correction of the nose bridge contour will likely yield better and longer-lasting results; but revision nose surgery results in more and prolonged swelling, and so may not be advisable right before your wedding.
Filler injections to the nose are a higher risk treatment, and the risk of vascular occlusion is likely increased in the setting of previous nose surgery.  Please discuss your concerns with your rhinoplasty surgeon, and consider nose filler treatment either with him/ her or a person very experienced with both nose fillers and nose surgery.  Good luck!

William Portuese, MD · Answer

Since you have a big wedding coming up shortly, it's probably best at this point to just try some filler so that you can get through your big day looking great. There are risks with putting filler in the nose, so just be aware to ask your provider about it. It's important to wait  at least a year after the primary rhinoplasty, then you can consider placement of cartilage graft in that area. It appears that you have An inverted V deformity which is going to require a spreader graft placement in that area and possibly an online graft as well. Very important know how much cartilage you have left over on the inside the nose for grafting purposes.

Post Open Rhinoplasty dents in nose, should I try filler or get a revision surgery? (Photo)

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