Can I get nose fillers on my nasal alar crease? (Photo)

Question

My nose is too pointy after my revision rhinoplasty. My doctor put cartilage grafts to "refine" my tip because it was round and I absolutely hate it. Its like there are dark lines around a pinchy tiny tip. I want it to be round again!!!! I heard that fillers on the alar crease can cause skin of the nose to rot and fall. A few surgeons I consulted in LA refused to do it. Can I learn more about this? I just want a rounder nose without surgery!

Alexander Rivkin, MD · Answer

Hi and thanks for your question. Yes, using injectable fillers to achieve this kind of post surgical rhinoplasty correction is what I do in my clinic daily and have been doing for 14 years. The tip is an area that deserves special care and attention, but getting rid of that "pinched" look is possible. I like to use a temporary, reversible filler like Voluma in this area. It gives great natural results that last for one and a half years. The bonus to Voluma being a hyaluronic acid filler is that it is completely dissolvable at any time with a simple enzyme injection. After the Voluma is gradually absorbed by the body, you will have the option of either using that filler again or going with a permanent filler like Bellafill. Feel free to contact us anytime for more information. Hope that helps.

Eric M. Joseph, MD · Answer

Many people with thin nasal skin may develop visible cartilage irregularities after rhinoplasty surgery. In our experience, microdroplet Silikon 1000 injections may help to smooth out the edges, and provide a more natural looking nasal appearance. I hope this helps! Sincerely, Dr. Joseph

Jason Emer, MD · Answer

yes you CAN put fillers here there is a higher risk of vascular occlusion or necrosis which can lead to scars. If you are willing to take that risk see an expert. cannulas can help limit complications but do not prevent them. Best, DR. Emer.

P. Daniel Ward, MD · Answer

Yes, fillers can be safely placed here, if done properly. This is not something that I would recommend that you have done by a non-facial plastic surgeon injector. You want somebody with a lot of experience with noses and rhinoplasty to help ensure that the injection is done safely. I think that you will be super happy with the results.

Kristina Tansavatdi, MD · Answer

Fillers can be safely injected to the nasal tip to soften the harsh outlines you are noticing in the tip. The key is having the injection performed by a rhinoplasty surgeon who has a keen understanding of the anatomy of the nose and location of crucial blood vessels. It is correct that the fillers can cause the skin to die if the filler is injected into an important blood vessel, occluding it, and causing the surrounding skin then to lose blood supply and die. I encourage you to meet with a plastic surgeon who operates on the nose frequently to have this injection performed.

Johnson C. Lee, MD · Answer

Thank you for your photos. The surgeons who described the skin necrosis are correct. There are known reports of permanent skin injury on the tip of the nose due to injections. That being said, it is possible to inject the areas on the side with filler making sure to avoid the major arteries in the area yet you should still be aware of the risk of skin necrosis. If you do decide to undergo injection, make sure you see an experienced injector who is willing to only inject small amounts at a time to lower your risk of complications. Hope this helps.Johnson C. Lee, MD 
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

Can I get nose fillers on my nasal alar crease? (Photo)

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