Permanent nose filler ischemia - is rhinoplasty still a possibility?

You had embolization of the PMMA into your nasal vessels, luckly you did not get a frank and full thickness skin / mucosa necrosis, but you had split-thickness necrosis with a good subsequent healing.

This means your skin is fibrotic, in a shortfall and lacks expandability, an expansion needed in any rhinoplasty but massively in an asian nose; should this be the case you might be a case with technical limitations or even needing skin reconstruction at the nose.

I need to see some images for a grounded assessment.

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

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

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.

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.

Whether you are a good candidate will depend on your physical exam, degree of scar tissue, goals for surgery, and medical history. If you are otherwise healthy and did not have an occlusive event that was so severe that it results in significant tissue loss, it is very likely that you are still a candidate for a surgical rhinoplasty. You should meet with a surgeon with advanced training in rhinoplasty who can discuss your options based on the above factors to come up with a plan that works for you.
Sean M. Fisher MD Aesthetic Plastic Surgeon Seattle, WA