Visible cartilage in nose tip after Rhinoplasty - is filler the best approach? (Photos)

Fillers are not the best approach. The best approach would be a revision of rhinoplasty. The cartilage graft needs to be removed and probably replaced with a different position graft, if necessary. Your breathing problem will also be addressed. You may have internal nasal valve collapse.

Best Wishes,

Gary Horndeski, M.D.

Based on your photos, you appear to have very thin nasal skin and visible edges of cartilage involving your nasal tip. And our experience, microdroplet Silikon-1000 nasal injections are an excellent alternative to revision surgery for camouflaging these edges, and for creating a less operated, and more pleasing nasal appearance. This however would not address any Airway issues you may have. I hope this helps! Sincerely, Dr Joseph

I'm sorry, but I think that revision rhinoplasty is the best response here. You have thin skin, and the cartilage will only get more visible over time. Filler may help a little but I don't think it is a good long term solution. We can, however, fix this readily surgically.

Patient with thin skin may show contours and edges of cartilage graft used for tip improvement. This can be camouflaged with placement of thin fascia or temporary with filler. Collapsing of the lateral nose wall during inspiration may need correction with a cartilage graft. Hope this helps.

Using filler in such thin skin might not be the best idea., the graft can be removed and might be the best options. Also the tip cartilage can be covered with a small piece of fascia tissue taken behind the ear

These bumps will not respond well to fillers. Best option is to excise them to soften the tip appearance. For breathing issues you might need to be evaluated to diagnose if it is a nasal valve problem or septal problem.
Regards
Dr.Janjua

Given the amount of time that has passed since your surgery, performing an intervention for your continued concerns is valid. Given the blanching and tightness of the region, I would be very hesitant to put filler in this region. Filler is essentially a semi-liquid/solid (sol) implant, and this could potentially compromise blood flow to this delicate thin skin. Given that it blanches, the blood supply is already intermittently compromised.

Due to your continued functional and aesthetic concerns, I would recommend that you need the guidance from an experienced revision rhinoplasty surgeon and avoid filler.

Hello and thank you for your question. Based on your photographs, the best way to fix this is with a revision rhinoplasty. Maneuvers for your surgery would include nasal tip deprojection, followed by placement of a mastoid fascia tip graft to help improve the contour of your tip. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

I suggest you schedule second opinion consultations as in person consultations.
For a second opinion consultations come prepared to bring with you a complete set of proper before and after pictures and a copy of your operative report.
These are available from your providers office if you request them.
You’re not going to get a proper second opinion consultation by posting on this website.
In order to make a quality assessment we have to review all the information in detail.
The one before and after picture you included looks quite good.
Best,
Mats Hagstrom MD