Filler in pyriform aperture after rhinoplasty?

Question

Hello! I have been told by many providers that filler in the pyriform aperture after rhinoplasty was not possible due to the vascular risk and anatomy uncertainty. Is there anything else that can be done in that area for the nasolabial fold?

Anna Chacon, MD, FAAD · Answer

Thank you for your question. The pyriform aperture, being a bony structure at the base of the nasal cavity, can indeed pose challenges for filler injections due to the complex vascular anatomy surrounding the area. The risk of vascular complications, such as inadvertent injection into a blood vessel, is a significant concern.

However, there are alternative approaches to address concerns in the nasolabial fold area. Here are a few options:

Dermal Fillers in Adjacent Areas: While direct injection into the pyriform aperture might be risky, dermal fillers can be strategically placed in nearby areas to achieve a similar aesthetic effect. This can help in softening the nasolabial folds and providing a more balanced facial appearance.

Fat Grafting: This procedure involves harvesting fat from another part of your body and injecting it into the desired area. Fat grafting can provide a natural-looking volume enhancement and is often used to address deeper folds like the nasolabial folds.

Surgical Options: If you are looking for a more permanent solution, surgical procedures such as a facelift or midface lift can help in reducing the prominence of nasolabial folds by repositioning the facial tissues.

Skin Tightening Treatments: Non-invasive treatments like radiofrequency or ultrasound therapy can help tighten the skin around the nasolabial folds, providing a subtle lift and improvement in the appearance of the folds.

It's crucial to consult with a board-certified dermatologist or plastic surgeon who has experience with post-rhinoplasty treatments to discuss the best and safest options for your specific case. They can provide a comprehensive evaluation and recommend a personalized treatment plan.

I hope this information helps!

Best regards,

DHH Med Spa · Answer

Your providers are correct that this may be higher risk after surgery but Im guessing they dont have ultrasound and that is perhaps their hesitation. Perhaps seek an experienced provider with ultrasound. Sculptra is a safer option here as well as it is mixed with water and will aspirate blood more easily if you are in a vessel. Multiple sessions are usually needed but that is my go-to vs fillers these days.

Filler in pyriform aperture after rhinoplasty?

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