1 year post-op- what needs to be done to correct depression on the bridge of my nose? (Photo)

Hello, and thank you for your question. Surgeons can sometimes correct bumps, asymmetries, and deficiencies on the nose with simple injections of hyaluronic acid (HA)-based dermal fillers such as Restylane and Juvederm. Non-surgical rhinoplasty using dermal fillers is an effective solution to correcting a previous rhinoplasty that didn’t give you the results you wanted. The HA fillers produce a beautiful, new shape to your nose without the need for revision surgery. Keep in mind that fillers are only a temporary solution, although results can last for many months at a time.

I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon, particularly one with extensive experience with injectables. Such experts will know how much filler to use and where to precisely inject them to achieve the most natural-looking results. Your surgeon will assess your nose, recommend the best approach to address your concerns and goals, and help ensure the best possible results.

You could have a revision rhinoplasty to smooth out the dorsum of the nose. Another option is fillers but this may need to be repeated.

If you’re just looking to have the indent filled, microdroplet Silikon-1000 nasal injections may be considered for a permanent fill. This may be reasonable if you’re ok with the angle between your nose and upper lip, and your front view. Hope this helps. Dr Joseph

Only on the basis of in person consultation one could decide what is the best way to correct this residual deformity. Very likely, injection of soft tissue filler may be the way to do it. Discuss this option with your surgeon. Good luck.

There are several options. The depression could be filled in with cartilage or filler. The other is to lower the bridge above and below. You can still lower those areas and your nose will not be too small

Hi. Looking at your pic there looks a small depression on dorsum of your nose. Best option will be to undergo revision rhinoplasty which will be permanant solution. Other option is to use filler injection but may require repeated injections. We have also used fat fill for such cases with good results. Hope I have cleared your doubt Thanks for posting your query. All the best.

Solely based on the photo, it appears that you possess a few residual issues (of course, a physical exam would be needed to make a definitive diagnosis). Your most obvious issue resides in the keystone area, where the bony elements of your nose meet the cartilaginous elements, approximately halfway down the bridge. Some might argue that simply filling in this depression would solve the problem, but I disagree: it is likely you need the bony element reduced (filed down) a slight bit more to produce a truly straight profile, and it appears that you lack columellar support (I’m guessing that when you smile, your tip points downward). An inlay graft would solve the issues in your keystone area, and I would file the bump, as well as using the strut to fortify your projection. The scar tissue I would assess in person. In summary, a revision rhinoplasty would be your best bet for a long-term, safe, and handsome result. I would not suggest injections due to their aesthetic limitation, temporary nature or, for the injectables that are permanent, I dislike the hefty risks that accompany such products.

Options for nasal revision : theoretically there are two general ways to address the dip between the bridge of your nose and the supratip area. The first would be to further reduce the dorsal hump and the supratip area. This would probably result in a nose which looked too long for it’s now reduced projection requiring some shortening of the nose as well. The second option would be to fill in the gap between the bridge and supratip with a graft harvested from the septum or the ear. A temporary version of this type of correction would be with filler but I never use that myself since it is temporary and has some potentially dangerous risks.

Revision rhinoplasty is more difficult than primary rhinoplasty, so what's important to have a full set of facial photographs from all angles since the nose is a three-dimensional structure. Also important have very realistic expectations. One option would be to shave down residual dorsal hump present, or add a cartilage graft to the depression, or a combination of both. It's also important to know how much Cartilage is left over on the inside of the nose for potential grafting purposes. That information will be located on your Operative report.