Are there ways to see my blood flow and position of veins / arteries after rhinoplasty? Hoping to have a liquid rhinoplasty done

Question

Hello, I did two rhinoplast back in 2007 ad 2008 and wanted to to a liquid corrective rhinoplasty to address the tip of my nose that is still a bit droopy but was concern with the scar tissues and the displacement of the veins and arteries that resulted from my first surgeries . While my injector will use a canula and all the time he needs to work on placing the product safely, I was wondering if there were any ways to see how my blood flow could be looking like in that area. Thank you.

Ryan Rebowe, MD · Answer

There is no way to view the veins and arteries in the nasal area in a typical clinic setup. While there are some injectors that will utilize ultrasound in parts of the face to identify vessels prior to injecting, this is not standard practice. A good, trained injector will follow the patterns of injection that reliably allow him or her to avoid known anatomic problem areas. This, along with the techniques that you previously mentioned, will allow for a safe injection practice.

Mark McRae, MD · Answer

You are right to be concerned about liquid rhinoplasty after previous rhinoplasty surgery. Make sure you are being treated by a board certified plastic surgeon. Vascular compromise is a major complication of liquid rhinoplasty, but is more common after a surgical rhinoplasty. This is likely due to fibrosis and scarring that creates a much more confined space for filler to go and higher pressure gradients with injection. I have seen blanching after injecting 0.1 cc of fat / filler product in this patient population and have seen presentations given on this topic at national meetings (Dr Jamil Ahmad gives an excellent talk on this topic for plastic surgeons).The injector must be experienced in dealing complications and so please do your research and proceed with caution. In terms of vascular mapping, there are techniques for mapping vasculature but I do know of anyone that has tried this in the setting of liquid rhinoplasty. It might be a good idea though as this technology does exist. Even if you had it in your case, I do not think it will appreciably decrease your risk of vascular compromise. Instead make sure the surgeon that you choose has experience with this procedure, and goes very slow with low volume injections.

Are there ways to see my blood flow and position of veins / arteries after rhinoplasty? Hoping to have a liquid rhinoplasty done

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