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
July 22, 2025
Answer: Persistent Nasal Fullness After Filler – Filler or Scar Tissue? 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.
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July 22, 2025
Answer: Persistent Nasal Fullness After Filler – Filler or Scar Tissue? 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.
Helpful 1 person found this helpful