Do I have to dissolve filler in my nose before rhinoplasty?

Question

I'm interested in Asian rhinoplasty, but I have filler in my nose and have read that I need to dissolve before undergoing the procedure. Is that something the operating doctor can do for me the day of or does it need to be done months in advance? And if I do get it, what if I'm only able to successfully dissolve 60-75% of it? Will that prevent me from getting the procedure done?

Donald B. Yoo, MD, FACS · Answer

Hi simplepodo

Ideally, filler in the nose should be dissolved prior to surgery so that the surgeon has a chance to make the most accurate assessment of your nose prior to making permanent changes. I require my patients to have the filler dissolved at least 1 week prior to surgery, and this is sufficient time for the majority of the filler material to be absorbed by the body. Any residual amounts of filler can be removed during surgery.

Bora Ok, MD · Answer

Hi from Istanbul! I recommend dissolving any fillers if possible before proceeding with rhinoplasty. However, throughout my career, I have rarely encountered fillers that could be completely dissolved. Since fillers tend to create a capsule around themselves over time, the substances used to dissolve them often struggle to penetrate these capsules. Nonetheless, even partial dissolution is beneficial, and if it doesn’t dissolve, it won’t harm the outcome of the surgery. However, since fillers tend to disturb the lymphatic circulation, that might lead to prolonged swelling in the post-operative period. Best of luck on your journey!

Kim Joo Yeon, MD · Answer

Hello! First, you have to know which filler you got it done with, as there are many types of filler nowadays, and it's crucial to inform your rhinoplasty surgeon beforehand. Because based on the situation, your plastic surgery specialist will then inform you when is the best time for you to dissolve the filler or, in worst case, they might adviced you to plan the surgery for a later date when the product has dissipated naturally. 
If there is some filler present on the nose, opting to undergo rhinoplasty without dissolving it first may lead to suboptimal results. This is because the filler may gradually be absorbed or spread to adjacent areas, thereby compromising the desired nose height or shape. 
When you should get it dissolved depends on the clinic, because every clinic has a different opinion. Because ascertaining the height of the nose can be challenging due to the presence of swelling after dissolving procedure, I always advised my patients to get it done at least a few days earlier or at least 1 week before surgery to allow for the reduction of swelling. 
Hope this helps! Good luck!

Jeffrey Lisiecki, MD · Answer

There should be an attempt to dissolve the filler in advance, which may take one or more visits depending on how much filler you have in there.  I like to do the last dissolving at least two weeks before surgery.  It's up to your surgeon, but to me it's OK if some of it can't be dissolved--this is not uncommon and sometimes we can cut out remnant filler during surgery, or sometimes some will be left behind.  It should not prevent you from getting the procedure done if there is still a little filler left behind.

Jacob Tower, MD · Answer

Hello, hope you are well. Every case is unique, but I generally advise dissolving filler 2 weeks prior to rhinoplasty. I think this is especially important for dorsal augmentation, because I want to see the natural structure of the nose before I start to work on it. Rest assured we deal with these issues all the time, and having filler in your nose should not be a big obstacle that would prevent you from having surgery. Sometimes, if enough time passes, it's not necessary to dissolve filler at all because HA fillers dissipate naturally.
Best,Dr. Tower

Lexie Wang, MD · Answer

I would consult with your surgeon and see what her preference is. Some surgeons say it doesn't matter, others say absolutely dissolve the filler. Usually the dissolving can take ~2-3 days so sometimes it is not a good idea to wait until the day of surgery to dissolve. Also, if the surgery is an open procedure, it may not matter because your surgeon will likely find the filler at the time of surgery and can simply scoop it out. Good luck!

Sean Fisher, MD · Answer

I personally ask all of my patients who have undergone previous liquid rhinoplasty to dissolve their filler prior to surgical rhinoplasty. This is because in order to deliver a result that is in line with your goals, I need to be able to see the native structure of the nose on the day of surgery. The goal should be to correct the asymmetries or concerns that you have, which can be difficult if they are being masked by HA filler. Every surgeon will have different preferences for timing but this may be affected by how many prior liquid rhinoplasties you have undergone and how much residual filler appears to be present. This could be determined at the time of consultation and pre-operative appointments. 
Sean Fisher Aesthetic Plastic Surgeon

Zamir Paez, MD · Answer

Yes, it is advisable to dissolve nasal filler before undergoing rhinoplasty, as fillers can interfere with an accurate assessment of nasal anatomy and surgical outcomes. This is typically done weeks or months prior to surgery to allow the tissues to stabilize.If the filler is only partially dissolved, your surgeon will assess whether the procedure is still feasible. It’s important to discuss this with your specialist to plan appropriately and achieve the best possible results.

Michael S. Kluska, DO · Answer

it is probably in your best interest to dissolve at least 50% of the filler that you have in your nose from Liquid Rhinoplasty prior to a traditional surgical rhinoplasty. The reason for this is that once the filler wears off after a surgical procedure, your nose shape may change and be different than what you expect. The filler should be dissolved approximately 30 days or more before the day of your surgery.

William Portuese, MD · Answer

Placement of filler in the nose distorts the anatomy of the nose itself, so it's best to dissolve the filler several weeks ahead of time. Rhinoplasty is a procedure that is performed in millimeters, so it's best to go in to the procedure with your normal anatomy, not an artificial anatomy

Do I have to dissolve filler in my nose before rhinoplasty?

Answers (10)

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