Nose filler after 4 years - can this be dissolved or could it be scar tissue? (Photos)

Question

Hello, I got nose filler on my nose in April 2021 and have been told that it will dissolve in a year. Yet four years later, in 2025, I still have nose filler at the tip of my nose. It looks bigger and longer than it was. What should I do? Is it still allowed to get hyaluronidase? Is it true that I can have scar tissue on my nose if so? Please help

Anna Chacon, MD, FAAD · Answer

Thank you for your question and for providing clear comparison photos. What you’re describing—visible fullness or prominence at the tip of the nose several years after HA filler—can happen, though it is uncommon.

Possibilities to Consider:
1. Persistent Hyaluronic Acid Filler
While HA fillers (like Juvederm or Restylane) are marketed to dissolve within 12–18 months, some filler can remain for years, especially in areas with limited lymphatic drainage like the nose. The tip is also less dynamic, meaning less mechanical breakdown. This is not unusual and can sometimes resurface or migrate, making it appear larger over time.

Yes, you can still receive hyaluronidase even years later. It’s safe and effective for breaking down residual filler. A small test spot is usually recommended to assess for overcorrection or sensitivity, especially if you've never had it before.

2. Scar Tissue or Capsule Formation
It’s also possible that the area has developed fibrosis or a capsule—a dense area of scar-like tissue around the filler. This can occur even with HA fillers, especially after repeated treatments or inflammation. Scar tissue won’t dissolve with hyaluronidase, but it may soften over time or respond to steroid injections, microneedling, or RF treatments.

3. Filler Migration
Filler can subtly shift downward or become encapsulated, creating an exaggerated shape at the nasal tip. This can contribute to the longer-looking nasal profile you mentioned.

What You Can Do:
Ultrasound evaluation (if available) can distinguish between residual filler vs. scar tissue.

If it's filler: Hyaluronidase injections are still appropriate and can improve shape significantly.

If it’s scar tissue: Kenalog (steroid) injections or gentle needling may help break up fibrotic tissue.

If structure has changed permanently: A surgical consultation may eventually be needed if you're unhappy with the shape, though this is usually a last resort.

Thank you for your patience in managing this—it’s a frustrating but solvable issue with the right approach.

Nelson Lee Novick, MD · Answer

Treatment depends upon what filler was used.
If a robust HA filler was used, intralesional hyaluronidase to dissolve it would be a wise start.
If a permanent filler, such as Bellafil or silicone was used, then the scar tissue below the surface engendered by the presence of these kinds of  foreign substance fillers would require the use of an algorithm of varying combinations, concentrations and amounts of intralesional anti-inflammatory agents. 
Semipermanent fillers, such Sculptra and Radiesse may also require the above algorithmic approach, since they, too, do not have a specific dissolving enzyme, as so the HA fillers.
The prior use of gentle subcision to break up any of the above filler masses is sometimes needed to allow for better exposure to the injected treatment materials. 
Surgical removal carries the risk of leaving stretch scars and stitch tracks and, in my opinion, would be a measure of very last resort. 
You would be wise to make sure to consult an experienced, board certified cosmetic dermatologist filler expert. Hope this helps and best of luck.

Nose filler after 4 years - can this be dissolved or could it be scar tissue? (Photos)

Answers (2)

Recommended reading

Everything you need to know about Nonsurgical Nose Job

Our mission is to create a world where every investment in modern beauty is Worth It.

Nose filler after 4 years - can this be dissolved or could it be scar tissue? (Photos)

Answers (2)

Browse related questions

Recommended reading

Everything you need to know about Nonsurgical Nose Job

Our mission is to create a world where every investment in modern beauty is Worth It.