Safe to Have Filler for Nose Bridge Until Revision Rhinoplasty?

I've had Rhinoplasty 3 months ago, and the Dr. "overscooped" my nose. So now it looks like I have a flat face with a 6 yr olds nose. No surgeon will even consider revision on me until 1 yr.

Is it safe for me to get filler to build my bridge up until surgery? Also I had a very bad recovery with my rhinoplasty, will building the dorsum be as difficult as a full rhinoplasty?

Doctor Answers 9

Your overscooped nasal bridge may benefit from Non-Surgical Rhinoplasty.

Dear Lostnose,

If you like, feel free to email me a profile, and frontal, up-close picture of your whole face.

I'll be happy to comment on the possibility of permanent injectable fillers as a solution to your concern.

I use fillers for overscooped bridges all of the time. I will use a Surgiform ePTFE implant in severe cases.

I hope this helps, and best regards.

West Orange Facial Plastic Surgeon
4.9 out of 5 stars 421 reviews

Fillers are not a good idea

It is not a good idea to have fillers placed in the bridge since it has only been three months since your surgery, and you will require an extensive revision nasal dorsal augmentation. It is best to just wait the full one year without placing any injectables into the nose and then proceeding with the proper nasal dorsal augmentation.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Filler may be good TEMPORARY solution before revision Rhinoplasty

First of all, I am very sorry you have to deal with this. I am sure this is very stressful and disappointing.

I understand how unhappy you must be. You don't walk to walk around feeling very self conscious about your nose. Given this, the only reasonable option for you is to have a temporary filler injected so that the scoop deformity of your nose is covered. Make sure that a temporary filler is used, and not something like Radiesse which will last a long time.

I usually wait 6 -12 months before I will perform a revision on somone who had a deformity caused by another surgeon. Yes, 12 months would be ideal. However, I also consider the emotional distress experienced by the patient. If it is something that is an obvious deformity, I believe it deserves earlier intervention.

The injection of the fillers should be timed so that it will be absorbed by the time you are ready for a revision. Then, a permanent solution to your problem, such as a graft, can be used.

John Diaz, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Filler for nasal bridge

Anything that will prolong the swelling or camouflage the future surgery is not a good idea. If you are definitely looking to have a secondary rhinoplasty, then I would avoid fillers int he nose. These can last along time and can interfere with secondary surgery.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Should be safe

I have used filler in this circumstance in the past.  I also use fillers a great deal now as the primary treatment for this area if this is a patient"s main complaint and have had great success with avoiding rhinoplasty in these patients.

W. Tracy Hankins, MD
Henderson Plastic Surgeon
4.9 out of 5 stars 299 reviews

Yes, by the person who will do the revision.

Fillers are a great way to correct a nasal deformity, either with no surgery or after surgery. You do need to wait a while after a rhinoplasty to do a revision to let the tissues settle. Usually this means a year. However, where there is a definite deformity, this can be pushed up. In the mean time, a hyaluronic acid filler can disguise the problem. The surgeon who does the revision, however, needs to evaluate you before the filler, photograph you, and know exactly how much was injected and what was filled. Therefore, that person is the best person to do the filler. You also need to have all the filler resorb before the revision. When you plan on doing the revision will, therefore, dictate which filler you use. There should be no problem in doing this, since the filler only adds a natural structural element to the tissues and should import no more scar than is already there form the previous surgery.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Revision rhinoplasty versus non-surgical rhinoplasty with fillers .

Fillers may be a good temporary solution but I would not use them in close temporal proximity to the surgery as this may interfere with correction.

IF you are considering fillers, I would veer away from the longer term filers such as Radiesse and instead consider the use of hyaluronic products that can be partially corrected or reversed with the off label use of hyaluronidase.

As stated, you will likely need a graft. Depending on your previous surgery, there may be variations in the donor site.

Many physicians are not willing to perform revisions for 1 year because swelling in this early postoperative period can make the appearance of the tip look excessively upturned. In this instance, it may be best for you to wait until the swelling resolves before making any further decisions. You will clearly develop a better idea by 6 months after surgery.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

I am afraid you have a difficult problem.

Hi. Secondary or revision rhinoplasty is quite difficult in general and requires a lot of experience. I have not examined you of course, but , probably, in Manhattan we would re-build the bridge of your nose with a diced cartilage graft wrapped in fascia. Pain is typically not bad, and patients are presentable in two weeks.

I would not use fillers as they will increase the internal scarring, and make surgery more difficult. I know this is not what you wanted to hear.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Filler not recommended until Revision Rhinoplasty

I would not recommend having a temporary filler placed until your revision surgery. The skin in the nasal dorsum is thinner to beign with. Having recent surgery and then placing filler in that area risks damage to the subdermal plexus which can cause potentially permanent changes to the overlying skin. I would say that you should wait at least 6-12 months before considering a revision, depending on the patient and circumstance.

For the best possible result I wouldn't have filler placed. Building up the nasal dorsum can be straightforward or difficult depending on the situation, the main issue revolves around the amount of tissue available to do this in the form of cartilage. Ear cartilage or rib cartilage may be required, an alternative is an implant but that carries a risk of infection. I hope that helps you.

Samson Lee, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 7 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.