What is the best way to fill in the hole/dent/missing tissue on my nose? (Photos)

Question

Hi I have been botched 3 times and had my fourth revision. The surgeon did an amazing job. The issue is we’ve done microneedling and the scar is still there which is okay because I’m hoping more misreading will take it away. What is the best way to fill in the hole/ dent/ missing tissue? Nano fat, filler, or do I need another revision? Thank you

Alejandro Nogueira, MD · Answer

I perceive total skeletal collapse, very bad condition of the skin cover of the nose, and a myriad of other issues here (short nose, over rotated tip, nasal valve collapse, etc).

I do not recommend any skin treatment like microneddling or injections into the nose; better wait 1-2 years for total stabilization and then reconsider a revision... but this time a comprehensive, integral and top quality one.

Andrew Miller, MD · Answer

Based on your history of multiple surgeries, I would do filler in the dents first to see how it looks. It the results are good, then silicone can be placed gradually to give a permanent effect. Be sure to see an expert injector for consultation.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty with placement of a mastoid fascia graft in the supratip to help smooth that area. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Eric M. Joseph, MD · Answer

I can see that there is a small circular indentation involving your right nasal tip. Depending on your examination, microdroplet Silikon-1000 nasal injections may be considered for filling this and for improving upon your nasal tip symmetry, without the inconvenience, expense, and uncertainties associated with another rhinoplasty. I hope this helps! Sincerely, Dr Joseph

What is the best way to fill in the hole/dent/missing tissue on my nose? (Photos)

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