Permanent Filler for Non-surgical Rhinoplasty After Radiesse?

I'm considering getting a non-surgical Rhinoplasty for the first time by using Radiesse. I read online that Radiesse nose job can last 10-24months. When Radiesse is almost gone, what does the nose look like? Are there some signs so that I know I should go back to get a re-injection before nose returns to original/flat shape?

Also, is it safe to do permanent filler injection (eg. Aquamid, Artefill) for nose job next time, after using Radiesse this time? If yes, do I need to wait until Radiesse is completely gone, then do permanent filler? Or is it safe to use permanent filler on nose while Radiesse is still there? Thanks!

Doctor Answers 5

Filler rhinoplasty

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Wow! That is a barrage of appropriate questions. Radiesse can indeed be used to fill areas of the nose that are deficient. It's duration is variable in each individual, but may last 12-24 months for some. As the material is absorbed by your body you will see a gradual return to your present appearance. At that time you can make a decision about a more permanent filler. Be aware that permanent fillers will remain in place as your nose ages, thining your nasal skin, cartilage and bones. The material may therefore become more visible with time. No filler is FDA approved for cosmetic nasal augmentation. Aquamid is not available in the U.S. Good luck!

Radiesse/Permanent fillers for Rhinoplasty

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In my experience Radiesse has had good results for limited indications and lasted about 15months. At present I do not use permanent fillers because of concerns about problems but that is a biased opinion., Be sure you go to someone who has used a lot of it and has long term follow up. You may consider autogenous grafts (cartilage, fascia,etc) which are easy to obtain. Also, I would recommend allowing all of the Radiesse to "dissipate" so that you get the best results with the new filler.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

Non Surgical Nose Shaping

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Dear Tina 2009

Radiesse has been advocated for shaping the nose in many papers. The longevity is variable- 8 months to several years. Restylane also works well and can last a long time. It is relatively straight forward to shape the nose with an injectible filler. Of course there are risks, but with careful technique complications are uncommon. Using Fillers in the nose is 'off-label' or not appproved by the FDA.

I would not recommend perrmanent fillers in the nose- if you have a problem this could cause disfiguring changes.

You can have touch ups with the filler at any time- you do not need it to dissipate to add more for shaping.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Fillers and non surgical rhinoplasty

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It is best not to place two products in the same area at the same time. Permanent fillers might create lumps, granulomas, as a reaction to the material, even five or more years after the procedure.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Similar process to facial wrinkles and folds

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Just like with correction of facial folds, temporary fillers used for reshaping the nose gradually dissolve and the correction slowly fades away. The timing of re-injection can be either after all the product has dissipated or before it's gone away completely. Either approach is reasonable.

The only situation where it is critical to let all of a filler resorb is if a patient is finally opting for a surgical rhinoplasty. This ensures that the surgical plan is tailored to the actual underlying anatomy and isn't going to change substantially afterward. With Radiesse, for example, I recommend my patients have waited at least 2 years from a Radiesse injection before considering surgical rhinoplasty.

The only permanent filler approved by the FDA for cosmetic use is Artefill. Its approval is for correction of nasolabial folds (a.k.a., smile lines or "parentheses"), but that makes it quite legal to use "off-label" for nasal augmentation.

As for the statement that permanent injectable fillers thin "your nasal skin, cartilage, and bones"...well, there's simply no evidence for that whatsoever.

The biggest risk with Artefill, for example, is that of granuloma formation in about 1 in 800 patients (0.125%). Granulomas are hard to treat and may require surgical intervention in severe cases. Of course, contrast that with the fact that 1 in 10 to 1 in 20 surgical rhinoplasty patients (5%-10%) seek revision (i.e., surgical intervention).

All the best,


David C. Pearson, MD
Jacksonville Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.