Can filler be used on a nose with an existing rib graft?

Thank you for sharing your questions, they’re really thoughtful, and it’s clear you’ve been through a lot already with your revision surgery. Let me break this down for you step by step.

Another rib graft on top of the existing one, Yes, in many cases, surgeons are able to place an additional rib graft if more support or extension is needed. It really depends on how your current graft has healed and the condition of your tissues, but it’s definitely possible.

Filler on a revised nose with a graft – Fillers don’t go deep enough to actually touch the graft itself. They sit within the soft tissue above the structure, so they don’t directly affect the graft or dissolve it. That said, filler in the nose always requires a very cautious approach, especially in a previously operated nose, because the anatomy can be altered, and the blood supply may be more delicate.

Safety and candidacy – Many patients with grafts can still safely receive fillers, but it should be done only by a highly experienced injector who understands both the surgical changes and the potential risks, like vascular compromise. When done properly, filler can improve contour or smoothness without harming your graft.

So yes, you may still be a candidate — but the key here is choosing the right hands for the procedure and making sure your goals are realistic. Both grafting and filler can work hand-in-hand, depending on what you’d like to achieve.

Putting rib on existing rib can be tricky. It may be better to remove the rib graft that is in now and replace it with another larger rib graft. You can use filler on a revised nose with a rib graft but you have to be very careful. There is a greater chance of filler compromising the circulation to the skin envelope with this scenario. The filler can go just below the skin or on the deep structure of the nose depending on how deep the needle is placed.

The most common reason for a permanent nonsurgical nose job after rib cartilage is visible edges of the rib cartilage. Many times, these can be camouflage. Unfortunately, I cannot help you with answering your hypothetical question. Good luck moving forward. Sincerely, Dr. Joseph