About Fillers Vs Revision Rhinoplasty?

I've been for the year visit. Still worried about the slight bump on the bridge. Crushed cartilage graft dissolved above the bump and below it (The area above the nasal tip) PS stressed that it may not turn out for the better after the revision,that it may re-absorb again. Another suggestion is to just "shave" the bump down, which may make my nose look slightly pointy (optical illusion). Which way do I go? What are the chances that it will re-absorb again and worsen the original outcome?

Doctor Answers 5

Fillers vs Rhinoplasty

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An in person evaluation and consultation is recommended to evaluate the current condition of your nose.  It is possible that once the nasal swelling went down over the cartilage graft, the hump was visible again and that more cartilage is needed.  The other option is as you mention to shave down the hump.  Please consult with a board certified specialist who can evaluate you, show you realistic expectation with computer imaging, and guide you to help achieve the results you seek.

Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Bump On The Bridge After Rhinoplasty

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Thanks for the question. Morphing your nose with computer imaging may be helpful for you to see what it would look like if the bump were removed vs. camouflaging it again with crushed cartilage during revision rhinoplasty. Another option would be the injection of fillers (nonsurgical rhinoplasty) such as Restylane, Juvederm, or Perlane to hide the bump  and help you decide if you like the look of a slightly higher bridge. The advantage of these fillers are that they are easily dissolved with an injection of hyaluronidase, if you either don't like the look of the filler, if too much product is injected, or if you are ready for revision surgery. Hyaluronic acid (HA) fillers such as these generally last 9-12 months but, in some cases, even a bit longer in the nose. 

Posting photos would be helpful the surgeons in this forum get a better sense of the size and location of your bump. Obviously an in-person examination would be most useful. You should certainly go over all of your concerns in detail with your rhinoplasty surgeon. 

Best regards,

Dr. Mehta

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 52 reviews

Revision rhinoplasty

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 We do not recommend fillers in the nose  unless there is a very small depression present. A small bump  or irregularity along the bridge line is best treated by gentle rasping performed as a touchup procedure. A cartilage graft is only used to augment a depressed area. Only on rare occasions do the cartilage grafts dissolve.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Fillers or Revision Rhinoplasty

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  Although you give a detailed description, there is subtlety in every rhinoplasty case that is hard to evaluate without pictures or an exam.  Fillers may be considered to bridge the gap or smooth irregularities.  Kenneth Hughes, MD Los Angeles, CA

Fillers vs Revision Rhinoplasty

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For patients like you I usually recommend a revision which is permanent. Fascia, whole cartilage, or diced cartilage can  be used. However fillers may be a reasonable alternative for minor irregularities. I need to see pictures to give you a more specific answer. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 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.