Is there a serious danger when putting filler in your nose for nonsurgical rhinoplasty?

Question

I had rhinoplasty 30 years ago. The doctor I believe took too much cartilage out on the left side and now the tip of my nose goes to the left all I really want is to straighten the tip. I also don't know the best filler for this?

Donald Groves, MD · Answer

Hello and thank you for your question. Unfortunately, you actually have a VERY difficult problem to fix. Your tip/nostril asymmetry and crooked nose after a prior rhinoplasty is due to either 1) an issue with the initial surgery, or 2) due to contractile scarring forces, which can unfortunately distort results over time as the underlying tissues heal and shrink, altering the shape of the nose. There are certain maneuvers which can be performed during rhinoplasty surgery to prevent such retraction and distortion- I actually perform these preventative maneuvers in all my rhinoplasty surgeries for this very reason. Because filler is not strong enough to overpower the extensive scar tissue present, you would need a revision rhinoplasty to properly correct your issue and to solidly reinforce the entire underlying framework to assure you get the BEST long term results. Anyone who tells you otherwise is doing you a HUGE disservice! Also, nasal filler carries can potentially make you go BLIND!

Revision rhinoplasty is truly a surgery of millimeters- they are the most technically challenging procedures in all of plastic surgery! Because your nose is the DEFINING feature of your face- I would only recommend seeing a surgeon who specializes in revision rhinoplasty procedures, and who has significant training and experience performing these surgeries. I actually trained under one of the world leading revision rhinoplasty experts (who performs 1,000+ nosejobs annually).

I recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with revision rhinoplasties) to thoroughly discuss your surgical goals, undergo a formal examination, evaluate your options, and develop a personalized plan just for you. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Andrew Miller, MD · Answer

Fillers or Silicone are commonly used to correct indentations or fill curves after rhinoplasty. If the correct technique is used by an experienced injector, the risk of vascular compromise is tiny. Use a hyaluronic acid filler like Juvederm so it can be dissolved if something untoward happens

Eric M. Joseph, MD · Answer

We exclusively use microdroplet Silikon-1000, a permanent soft tissue filler, for adding volume to the nasal tip after previous rhinoplasty. An examination would be necessary to determine your candidacy. Hope this helps! Dr Joseph

Jeffrey Lisiecki, MD · Answer

The risks of nasal filler can be very much minimized with good technique and certain safe practices.  That being said, filler is not effective for straightening a crooked nose. Without seeing pictures, if your goal is a straighter nose after a prior rhinoplasty, revision rhinoplasty is typically the answer.

Nima Shemirani, MD · Answer

Hi juliennecs! There is a risk of vascular compromise meaning the filler gets injected into a blood vessel resulting in skin necrosis or even blindness. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Restylane Lyft works great for a liquid rhinoplasty. Best of luck, Dr. Nima

Jennifer Levine, MD · Answer

Great question. Without seeing your photos, it's difficult to assess if a non-surgical nose job can help straighten the tip. While it's unlikely that filler alone - or liquid rhinoplasty - would correct this, a combination of PDO threads and filler may help.

Robert Ciardullo, MD · Answer

Potential risks of nasal fillers: The potential risk of injected nasal filler is vascular occlusion. This occurs when the injected material gets into a blood vessel and embolizes and blocks the flow of blood through that vessel. If the blood vessel goes to the skin of the nose a patch of skin can necrose or die leaving a cosmetic disaster. If the blood vessel travels to the retina it can cause blindness. Fortunately these risks are very rare. If you do have filler you should have it done by someone who specializes in this and who is intimately aware of the vasculature Of the nose. In some cases a patient might be better served having a small piece of Cartilage inserted to fill the gap. This has less risk may do a better job, and will be permanent rather than temporary.

Johnson C. Lee, MD · Answer

There are certain "danger zones" when injecting the nose where there are more prominent blood vessels that, if injected, can occlude and cause tissue damage or loss from lack of bloodflow to the nose. Therefore it is important to go to an experienced injector who is aware of how to inject safely. Also in cases of accidental injection into a blood vessel, they should the equipment and medications necessary to immediately reverse the filler to minimize any permanent damage. Hope this helps!

Johnson C. Lee, MD
Double-board certified plastic surgeon

Johnson C. Lee, MD
Double-board certified plastic surgeon

Is there a serious danger when putting filler in your nose for nonsurgical rhinoplasty?

Answers (8)

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