Is it safe to get a second nose job with permanent filler in the nose?

In general, filler is injected into the soft tissue layer of the nose, and it’s not typically seen or removed during rhinoplasty in our experience. The feasibility of surgery I’m your situation would require an examination. Hope this helps. Dr Joseph

Hello and thank you for your question. Without photographs and an exam in person, your question is a very difficult one to answer. I commonly perform revision rhinoplasty on patients who have injected nasal filler in the past, and this filler can be removed during surgery to ensure that all modification subsequently performed is due to the surgical maneuvers during the revision rhinoplasty and not due to the prior nasal filler distorting the appearance. With that said, you stated that your filler was indeed permanent. I am unsure of the type of filler this may be and if it can be removed.

In terms of the indentation on your nose, I cannot see this in your photos, especially if you have placed filler in that area as you stated. However, I normally reconstruct indentations as you described with soft tissue grafting. In terms of your nsotrils/ala, they do not appear widened to me. Further tip refinement may also be performed where the nasal tip cartilage is modified. Due to your prior rhinoplasty, the cartilage in your septum was likely harvested and so you will likely require MTF (cadaver) cartilage. The modification of your nasal cartilage can be done with trimming, stitching or grafting. If your septum is deviated and you have breathing difficulty, a septoplasty may benefit you as well.

The next step for you is to find the right aesthetic plastic surgeon. In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course. Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome.

After seeking out a board-certified plastic surgeon who specializes in aesthetic plastic surgery, I think the most important component of the consultation is to establish a good connection with your plastic surgeon. It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Much more information is needed, such as a full set of facial photographs from all angles, and a copy of your operative report find out what was accomplished in the first procedure.