Permanent nose filler ischemia - is rhinoplasty still a possibility?

Question

Hello, I am wondering if rhinoplasty is still a possibility for me after I had artefill injected to my nose November 2012 and had tissue ischemia after. After the injection I saw white under the skin (possible the product) and my nose and cheeks progressively turned red the next couple of days. A tiny wound (looked like an ulcer) formed and I saw my PCP for antibiotics. Skin never turned black and redness resolved 1-2 months. Because of this I never had anything done to my face, but am wondering if I am a candidate for rhinoplasty with augmentation as I have an Asian nose.

Eric M. Joseph, MD · Answer

If you are simply looking to raise your bridge appearance permanently, microdroplet Silikon-1000 nasal injections may be considered, since they are never associated with necrosis, embolism, stroke, blindness, infection, or biofilm. I hope this helps! Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. This is possible and safe to do in this setting. You may want to consider having a soft fascial graft in the tip to help add soft tissue in this area. With good surgical technique, you could likely 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

Seth J. Davis, MD · Answer

Based on your description, it is quite possible that you did experience a period of reduced blood flow to the skin - what is most important would be an assessment of the health of the nasal skin now. Risk factors in rhinoplasty are taken very seriously since the result of tissue loss can be devastating - and a challenging problem to fix. I would recommend finding a Facial Plastic & Reconstructive Surgeon who specializes in revision rhinoplasty, and have a thorough discussion of the risks that might be specific to your case prior to proceeding with any surgical intervention.

Thomas Spalla, MD · Answer

In short, it should be very possible to undergo augmentation rhinoplasty given the amount of time that has passed since your injection.

There may be some additional scar tissue that your surgeon will have to account for as well as an increased risk of healing uncertainty, but if the augmentation isn't too extreme, the stress on the tissue by the underlying framework should be reasonable.

Permanent nose filler ischemia - is rhinoplasty still a possibility?

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Permanent nose filler ischemia - is rhinoplasty still a possibility?

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