Rhinoplasty After Non Surgical Nose Job?

Hi. I had Radiesse (non-surgical rhinoplasty) injected into my nose (bridge & tip). Now I hate how my nose looks and want to get the proper, surgical rhinoplasty. The doc that did the Radiesse said I can have surgical rhinoplasty in 6 months. But another doc I contacted said he would not perform nose surgery until 1 year has passed. Now I'm confused. I really would like to get it done in 6 months. I can't believe I may have to wait 1 year?!

Doctor Answers 13

Radiesse prior to rhinoplasty

I would heed the advice of the surgeon who is recommending that you wait at least 12 months after Radiesse injection (nonsurgical rhinoplasty) before considering rhinoplasty. Other fillers used in the nose, such as Restylane and Juvederm, can be dissolved with hyaluronidase, in which case the surgery can be undertaken more quickly. However, Radiesse can last 12-18 months and therefore, to go into surgery too quickly would be ill advised. The presence of the product would complicate the surgery tremendously and reduce the likelihood of success.

Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

The nose will tell


This is an interesting scenario and an even more interesting response from your two surgeons. Radiesse used for non surgical rhinoplasty may indeed last for a year. So, it is expected that the surgeon who did not inject the Radiesse would want to wait at least a year for it to dissipate. This would allow your native anatomy to be better evaluated for someone who has never had the opportunity to evaluate your pre injected nose. The surgeon that injected the Radiesse has seen your nose in its native state and likely has photographs depicting it.

So, he/she probably feels comfortable with waiting only 6 months, at which time, a significant amount of the Radiesse will be absorbed. Take heart in the fact that the Radiesse will progressively absorb over time.

The nose that you hate right now will therefore progressively improve and, at worst, return to its previous appearance. This process may take 6 months or it may take a year. Personally, I would wait until the nose returns to its original appearance before proceeding to a surgical rhinoplasty.

Good luck!

Kenneth R. Francis, MD, FACS
Manhattan Plastic Surgeon
4.6 out of 5 stars 47 reviews

Rhinoplasty - the longer you wait the better

You need to be certain that all of the filler injecting to your nose is gone prior to having any surgical procedure. If not, a perfect appearing result now many not look so perfect when the remainder of the filler has resorbed. I would wait at least a year....

Evan Sorokin, MD
Cherry Hill Plastic Surgeon
4.8 out of 5 stars 76 reviews

Wait to have Rhinoplasty after Non-Surgical Nose Job

To be safe, I would wait up to one year before proceeding with surgery to ensure that all of the Radiesse has dissolved.  If you move forward with surgery while there is still some Radiesse left, a doctor may not be able to accurately define your problem areas.  I understand that you are unhappy with your nose and would like it fixed asap; however please remember that surgery is permanent and should not be rushed into.  Right now, fortunately you can wait for your nose to return back to normal.  If you decide to move forward with surgery too soon, you will be stuck with permanent results.  Good Luck!  

Paul L. Leong, MD, FACS
Pittsburgh Facial Plastic Surgeon
4.9 out of 5 stars 46 reviews

How long before Radiesse is gone after nonsurgical rhinoplasty?

If you had Radiesse injected into the nose, no one really knows how long it and it's effects will be there. 6 months is absolutely too short a time. One year may not even be enough. Radiesse can stimulate a collagen response that may last quite a bit in immobile structures like the nose. Be patient. Going in too soon will lead to less predictable results, increasing the chance that you will need a revision. If a hyaluronic acid like Restylane had been used then it could have been dissolved away and you could have surgery sooner. There is no way to dissolve Radiesse.

Minas Constantinides, MD
Austin Facial Plastic Surgeon
3.9 out of 5 stars 7 reviews

Non-Surgical Rhinoplasty Must Dissolve Before Surgery

You will need to wait at least a year before having surgery after you have had a non-surgical rhinoplasty. Unfortunately part of a rhinoplasty procedure is simply seeing how the nose looks during the operation. If you get a certain result while the filler is still present, it will inevitably change once the filler dissolves - which it is destined to do. Therefore, you must wait until the filler is gone before undergoing surgery. With Radiesse, this can be a year or sometimes longer.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

Nose surgery post injectable to nose is a growing issue

I like to wait one year before any surgery in your situation.  However, this is no absolute rule.  The issues are: the nose must be completely settled from the previous filler injection so the surgeon can most accurately plan to revise the nose to get the best result. This is my reasoning for the one year rule.

Robert Mounsey, MD
Toronto Facial Plastic Surgeon
4.7 out of 5 stars 11 reviews

Radiesse needs to dissipate before rhinoplasty

It is probably best to wait at least a year or two after Radiesse injected into the nose. The Radiesse needs to dissipate before undertaking a rhinoplasty procedure so to know where the true anatomy of the nose is without a temporary alteration in it prior to embarking on a rhinoplasty surgery.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Rhinoplasty after Radiesse

Radiesse injected into the nose will take about a year to dissolve. Furthermore, once the Radiesse has dissolved, it will allow the surgeon to properly evaluate your nasal problems so that a correct surgical plan can be created. Patience is a virtue!

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Worth the wait- but use your time wisely!

As I'm sure you know, Radiesse is a temporary filler that can be injected to many areas of the face provide a contour change. I feel the words "nonsurgical rhinoplasty" are misleading--more often, fillers such as these are used after rhinoplasty to provide nuance changes to the new nose form.

In any case, a surgical, true rhinoplasty will likely provide you with permanent, pleasing changes and may have the additional benefit of improving your breathing as well. Rhinoplasty is one of the most technical and "artful" procedures that we do as plastic surgeons- when we are looking at the structures of the nose, we want to be able to see exactly what we are sculpting, what will permanently be left in place to shape your nose. Any residual Radiesse can make that more difficult, and therefore make the situation more prone to miscalculation.

So what I suggest for you, is to wait until the Radiesse is completely dissolved, which takes 6-12 months. But that intervening time does not have to be wasted! Use the time to interview plastic surgeons with a particular affinity for nose surgery, and most importantly find one that you like and who you are comfortable with. Bring photographs of what your nose looked like before the Radiesse injections, so the surgeon can evaluate what will need to be done in surgery. you will also have the opportunity to point out what you don't like about the current, post-Radiesse shape of your nose. That can be a great help to the surgeon and may help to get just the right result in the end.

While I'm sorry you've had a bad experience so far, there are certainly ways to take advantage of your current situation so that you'll end up with the best result down the line.

Adam David Lowenstein, MD, FACS
Santa Barbara Plastic Surgeon
4.9 out of 5 stars 56 reviews

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.