7 years post rhinoplasty. Should I consider a revision or will filler help me achieve a slight curve and tip lift?

Question

I had a rhinoplasty that looked great after healing 5 plus years on, my nose has lost its definition and a bit of scar tissue has built up causing it to lose its shape. I had several steroid injections in the first few years of healing. I want a very slight curve in the nose and a tip lift. Can i achieve this with filler or should i get a revision? Pictures are of before my rhinoplasty, 1 year post op after steroid injections and present day which is 7 years after surgery

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. Hyaluronic acid dermal fillers can change the shape of your nose, slightly lifting the tip and making the bridge appear more curved. Non-surgical rhinoplasty with fillers produces results that can last for up to 18 months or more. If you’re still unsatisfied with your rhinoplasty results or want a more long-term solution, the changes you’re referring to can be made during revision surgery. 
Keep in mind that each subsequent nose surgery becomes more complex due to the loss of structural support and scar tissue. The importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon with expertise in rhinoplasty techniques. They will be able to review your surgical history, discuss your concerns with you, and suggest the best treatment to help you achieve your aesthetic goals.

Alan Gonzalez, MD, FACS · Answer

Hello @eliza bethany, and thank you for your question. Keep in mind that the nose like the rest of the face ages with time. The nose even when it has been operated is not always the same because the tissues tend to change over time due to gravity. This can be due to inflammation or other causes, for example allergies. The nose is one of the parts of the body in which one should try to intervene as little as possible. Just because you have one or several rhinoplasty revisions does not mean that it will improve. It can be counterproductive because cartilage is lost. It is my sincere recommendation that you focus on non-surgical treatments to improve the structures that are close to the nose and improve a little bit the tip of the nose. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Jeffrey Lisiecki, MD · Answer

You should be seen in person to discuss exactly your concerns and to see the shape and proportions of your nose relative to your whole face, and to see how firm vs soft and mobile the tip of your nose is. A little bit of filler placed appropriately can help increase the tip projection and define the tip, possibly to create a bit of a supratip break. The important thing here to note is that filler will make your nose bigger, and will adjust the proportions of your nose. Based off of your provided photos and description, you would probably be a better candidate for a tip revision.

7 years post rhinoplasty. Should I consider a revision or will filler help me achieve a slight curve and tip lift?

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