Filler on nose/Dangers of injecting vein across bridge

Question

Hi, I am interested in temporary filler to fill area from over rasping. I read that if the vein across nose bridge is hit, will go into eye area and or brain (causing permanent damage). I can see where mine is when I cough to bring it out. It is in the middle, hump area, a little to 'my' left (micro amount), about less than a quarter inch worth, then looks like it disappears. The last person I saw [PS] wanted to put temp/permanent Radiesse in there. Not a good idea (!) Wouldn't trust him about the vein either. I would like to know myself in testing where I go next to see who I may be dealing with if they really know what they are doing, as well as guide or help to make sure. Is everyone's in the area of nose I described ? Thank you for your knowledge...

Randy Wong, MD · Answer

I have used Radiesse often in the nasal regions and they have all done well. They have even trumped my recommendations for implant surgery in many cases. If you have a demonstrable vein in the bridge area, this needs to be taken into consideration. The complication of intravascular injection is rare but real. This can be minimized by your surgeon's techniques of careful bevel direction, aspiration before injection, and slow injection rate with use of a blunt cannula instead of a sharp needle.

Joseph A. Eviatar, MD, FACS · Answer

Fillers on the nose are a very nice way to reshape it. There is a chance of vascular occlusion and for this reason it is often safer to use a hyaluronic acid product such as Juvederm or Restylane because they are reversible should there be a problem. Radiesse can be a higher risk, (should there be a problem), because there is no quick way to reverse it if there is a problem. The risk with hyaluronic acid products is minimal. And of course there is larger risk with surgery.

Jacqueline Calkin, MD · Answer

Some of my happiest patients are those who have had post surgical defects corrected with a filler. If done carefully it is very safe and requires only a tiny amount of product (which makes it very affordable). Radiesse is not permanent or semi permanent, but like the hyaluronic acid fillers it is absorbable. It does tend to last longer, however, on average about 12 months. As others have said, make sure your doctor has a lot of experience with advanced use of fillers. It is not necessarily the same person you would choose to operate on your nose!

David A. Bray, Sr., MD · Answer

I agree with your surgeon. In my opinion, Radiesse is the best product. The risks are almos nonexistant. If tou can see a vein then it should be easy to avoid.

Jo Herzog, MD · Answer

Correcting a defect in the nose with a filler is very simple and satisfying. If you can see your vein, all the better as the doctor will be able to avoid it. Drawing back prior to injecting also makes the injection into a vein less likely, although always possible. Make sure that you trust the person that you choose to do this and that they have worked on the nose before.

Steven Wallach, MD · Answer

Facial fillers are being used in many different areas including for minor nasal deformities. While there is always a risk of injecting intravascular, it is extremely rare. I use facial fillers all the time and have used it for many different indications. Good luck.

Francis R. Palmer, III, MD (retired) · Answer

It's best to avoid veins when placing fillers in the nose which can be done by placing the fillers deeped within the tissues.

Eugene Mandrea, MD (retired) · Answer

If the vein is noticeable, it is much easier to avoid it than if it were unnoticeable.

	The Radiesse would be injected at a level well below the level of the vein. However, there might be a connection with a deeper vein which may in fact communicate with intracranial veins..

	Carefully chosing the entry point, the level of injection and carefully aspirating repeatedly before injecting, should result in an uneventful procedure. The cosmetic results are often very gratfying

Filler on nose/Dangers of injecting vein across bridge

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