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Is filler in the tip/lower lateral cartilage area okay?

I have been told by some rhinoplasty surgeons that fillers in the tip of the nose are OK, but have also been told that it could lead to issues from others. I have extremely thin skin and looking into a revision rhinoplasty for a few divets and uneven areas in the tip/lower cartilage area.

Doctor Answers 4

March 14th, 2014

Fillers for small irregularities after rhinoplasty

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Soft tissue fillers can be used in certain situations to correct deformities of the nose. One of the more common uses is to fill depressions of the nose especially after surgery.

There are several important considerations when using soft tissue fillers in the nose to improve safety and prevent both short and long term complications. Use temporary fillers NOT permanent (Silicone, Artecol). Use gel fillers NOT particulate (Radiesse, Sculptra). The amount of filler injected at one time must not be excessive as this can cause problems with not only the appearance but also the blood supply. Hyaluronic acid fillers are ideal for injection into the nose as they are temporary (usually last for over 1 year) and gel. Additionally, if too much filler is injected or there are problems with blood flow to the nose, an enzyme (hyaluronidase) can be injected to dissolve the product and reduce the risk of skin loss and scarring. Both Juvederm and Restylene are commonly used hyaluronic acid fillers. Another consideration is that you have had previous surgery which causes the skin to be less pliable, so injecting fillers can be more challenging. In these situations with thin skin and scar tissue, using a hyaluronic acid filler that is softer is better to avoid pressure necrosis and skin loss. Additionally, small volumes should be injected and sometimes this may need to be done over several sessions instead of a large volume in one session.

You would benefit from seeing a board certified plastic surgeon that performs both revision rhinoplasty and soft tissue filler injections into the nose to see what would be an appropriate option for you.
Jamil Ahmad, MD
March 3rd, 2014

While Not Necessarily The First Choice, Filler Can Be Used Very Effectively In The Nasal Tip

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Traditionally the best way to correct small defects following a rhinoplasty has been a small revision surgery using either small pieces of cartilage or soft tissue. More recently, we have been using small amounts of filler to correct subtle nasal tip defects. Used judiciously and artistically, it has been quite effective for those people with small contour issues that don't want to have another surgery. Interestingly, although the effect of the filler typically goes away over a 6-9 month period, when used in the nose it tends to last much longer (12-15 months), and I have had a few patients who haven't needed further injections after being injected for a second or third time. Importantly, you have to be very careful when injecting into the nasal tip. It is not without risks and should be done by a very experienced injector. Good luck.
Michael R. Menachof, MD

Michael R. Menachof, MD
Greenwood Village Facial Plastic Surgeon
4.4 out of 5 stars 28 reviews

March 3rd, 2014

Fillers placed in the tip of the nose

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 We do not recommend fillers to be placed and the tip of the nose. If there is deficient cartilage, then cartilage grafting techniques are employed to reconstruct the nasal tip which  is what should be in that area of the nose. For many examples, please see the link below to our rhinoplasty photo Gallery

Learn more: http://www.seattlefacial.com/photogallery/rhinoplasty_photos24.html

William Portuese, MD
March 1st, 2014

Fillers in the Nasal Tip

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Filers do have their place in the treatment of some nasal irregularities but I do not recommend their use in the treatment of the tip, especially in patients with very thin skin. Although surgery is a little more involved, cartilage grafts will provide a safer, permanent solution. Having said that I need to see pictures of your nose.
Richard W. Fleming, MD

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.