Nose contouring for atrophy - fat graft v silicone?

Question

-anesthesia resident, s/p tertiary revision 5/2012-bridge and tip widened with septal cartilage I have a persistent issue plaguing me- ATROPHY ALONG ENTIRE RIGHT LATERAL NOSE WALL AND TIP. ALSO SLIGHT 2-3 mm DEVIATION OF TIP TO THE LEFT. I believe the atrophy is causing the deviation due to reduced firmness. Fat graft v silicone v ? Goals: to restore fullness to R side and symmetry, restore straightness and discrete line of light, nonsurgically preferably. Will be in SoCal in May for consults.

Kenneth Hughes, MD · Answer

Fat or filler can be used, but you would prefer something durable such as a cartilage graft.  An examination would be necessary to determine anatomical constraints and concerns.  Find the board certified plastic surgeon with ELITE credentials who performs hundreds a year.

Robert Mounsey, MD · Answer

Damage to the skin soft tissue envelope can be difficult to correct.  There are a variety of tissue that can be used to improve this.  Fat, fascia, cartilage and bone are optons. The best option should be natural and closely recreate the tissue that you are trying to replace. If structure is needed for support you may want to consider a more firm tissue.

William Portuese, MD · Answer

Do not consider using silicone in the nose, or any other fillers. After 3 rhinoplasties, the nose will never be perfect.  Building up the sidewall can be accomplished with several options including cartilage and fascia.  Best to look for a revision  rhinoplasty specialist that has thousands of rhinoplasty surgery procedures under their belt.   This will be a challenging procedure, so weigh the benefits/risks.

Samir Shureih, MD · Answer

Asolutely no silicone injections. You are a doctor review the literature about long term silicone injection problems.

	Find a board Certified Plastic Surgeon in your area to work with. It may take more than one modality of treatment to achieve the results.

Shervin Naderi, MD, FACS · Answer

First off, there is no reason to go to Southern California unless you live there or are from there.  There are plenty of good and plenty of bad plastic surgeons everywhere regardless of zip code.  

	 

	If you prefer a non-surgical route then try Restylane first and see if you like it.  Do not go to fat right off the bat and stay as far as you can from Silicone or Artefill.  Surgically, fullness can come from crushed cartilage, fascia or Alloderm. You have to evaluate the tip from the base view and see if in face it deviates or is it an illusion due to the lateral nasal wall depression. 

	 

	Good luck

Nose contouring for atrophy - fat graft v silicone?

Answers (6)

Answer: Nasl deformity

Answer: Nasl deformity

Answer: Definitely not silinone

Answer: Definitely not silinone

Recommended reading

Everything you need to know about Revision Rhinoplasty

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

Nose contouring for atrophy - fat graft v silicone?

Answers (6)

Answer: Nasl deformity

Answer: Nasl deformity

Answer: Definitely not silinone

Answer: Definitely not silinone

Browse related questions

Recommended reading

Everything you need to know about Revision Rhinoplasty

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