Can I get HA fillers in the nose bridge after a unsuccessful rhinoplasty? (Photo)

Question

I had a rhinoplasty about 19 months ago but I am not content with my results. After the operation my cast shifted, while I was sleeping. This caused fluid to go to the left side of my nose which my surgeon had to drain during 2 of our consultations. I believe this affected the appearance of my nose since now I have an indention on my bridge which makes it look broken. I would be thankful if you could tell me whether I can inject HA fillers in my bridge to make it look more straight.

Jason Emer, MD · Answer

Hello and thank you for your question. Honestly, surgery is the best option to address your situation- you have what's known as a "saddle nose deformity" which is due to collapse of the mid nasal vault from inadequate support from the underlying septal cartilage. Fillers would be the main non-surgical option, and but they would only partially mask the appearance of this indentation, and are only temporary in nature. The reason for the mid vault collapse in your case is likely due to over-resection of the cartilage in that area during your initial surgery. Correcting this properly, and addressing the overall shape of the nose are actually common reasons people seek out and undergo a revision rhinoplasty procedure, which would provide optimal results to achieve your goals. Given you've previously had a rhinoplasty, and there is no doubt extensive scar tissue present in your nose, and fillers are likely going to be unable to overcome the scarring, and only an open revision rhinoplasty can best address your issue.

In addition to addressing your concerns, your septal cartilage (or an off-the-shelf alternative) would be harvested (removed) and turned into multiple cartilage grafts, which would then be secured into different areas of your nose for structural support, including in the columella (middle bottom portion of your nose between your nostrils) to really reinforce the tip and alae, and prevent recurrence of the alar retraction. As you've already had a rhinoplasty, likely your septal cartilage has been used already, so we'd need to use an off the shelf alternative (MTF cartilage).

The open approach is very effective in facilitating complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look. Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery. I would only recommend going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible.

Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the photos and description provided.

Dr. Donald Groves, our expert facial plastic surgeon, has extensive training and experience with complex rhinoplasty surgeries, so I’d recommend for you to come see him (or another plastic surgeon who is extremely comfortable with rhinoplasties) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!

Dr. Emer

Eric M. Joseph, MD · Answer

Based on your photos, your upper bridge appears to be a bit low on profile. Depending on your examination, microdroplets Silikon 1000 injections may be considered for achieving a more pleasant nasal profile appearance by adding volume to the top. I hope this is helpful! Sincerely, Dr. Joseph

Nelson Lee Novick, MD · Answer

The short answer to your question is "yes, fillers can be used for filling and straightening nasal bridge depressions."  In fact, I personally have been doing this for nearly two decades even if true "saddle" deformities of the bridge. The one word of caution here is that you make sure that you consult with an experienced injector, since fillers in a nose that has undergone rhinoplasty is a much trickier situation since internal scarring and blood vessel changes can have occurred, which increases the risk of possible adverse reactions to the injections. So, look for a board certified aesthetic physician and ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.

Ronald J. Edelson, MD · Answer

Injectable fillers is one option. My recommendation would be a rhinoplasty revision. The cartilage of your tip what not lowered sufficiently leaving what is reffed to as a polly beak deformity. Once that part is lowered ( pretty straightforward revision ) your nose will look much better. To me this is a better solution to building up the bridge..

Solomon Facial Plastic - Thornhill · Answer

Hi there! thank you for your question. You may certainly use HA fillers in the bridge of your nose. It will last up until 1 year. Be sure to visit an experienced injector.

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