Will Nose Fillers help my African American Nose? Ethnic/African American Rhinoplasty. (Photo)

Question

I would like my bridge raised and just an overall thinner look to my nose. What is the best route rhinoplasty or could this be achieved using nose fillers? Im looking for the least invasive procedure as I am not keen on going under the knife. Also Im scared of scarring and keloids....which i had on my ears before but they were removed. What recommendations do you have to improve my nose?

Ran Y. Rubinstein, MD · Answer

African American rhinoplasty typically involves increasing tip definition via increased projection, cartilage grafting,  narrowing of the nostrils, and very conservative defatting of the underlying fat. The bridge is defined by building it up also via cartilage or implant grafting.Having said this, not everyone however is a candidate for surgery- in your case you are at a higher risk for keloid formation given your history.You can still get a noticeable natural result by just filling in the bridge and increasing the definition of the nasal bridge.  It makes it look more triangular rather than flat.  The ideal filler for you is one that is least likely to cause keloids such as the hyaluronic fillers i.e.  Restylane or Juvederm.  I have been using Juvederm Voluma over the past year because it can last more than two years with even better results than the older HA's.Good Luck.

Rod J. Rohrich, MD · Answer

In general fillers may help somewhat on the dorsum of the nose, especially on the bridge. Management of the ethnic nose requires the expertise and skill of a rhinoplasty surgeon with experience in this area as it is basically an augmentation rhinoplasty.  The surgeon needs to understand the proper aesthetics to maintain the balance of the patient’s ethnicity and facial features.
  If you truly want refinement, you will need a rhinoplasty done by a board certified plastic surgeon or ENT surgeon that has experience and expertise in ethnic rhinoplasty.

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for the questions.The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.In this regard, After having analyzed all the info. and photos provided to us, i recommend you perform an Open Full Rhinoplasty, includding narrowing of the nasal base and nostrils, with nasal bones treatment (controled fracture) and alar + triangular nasal cartilages re-shaping.With this procedure you get a delicate nose, better harmonize with your other facial features.Respectfully,Dr. Emmanuel Mallol Cotes.-

Larry S. Nichter, MD, MS, FACS · Answer

Fillers are only temporary but might help the dorsum of your nose somewhat for several months only. If you have pierced ears and not keloids there or elswhere you are unlikely to have keloids with a rhinoplasty. Always find a board certified plastic surgeon with expertise in African American rhinoplasty. See the below link for details on how to locate one in your area.

Jonathan Kulbersh, MD · Answer

Rhinoplasty is common performed to narrow and create definition in the nose.  The
cause for the loss of definition in the nose can vary from patient to patient.
 Some causes of a wide nasal tip and nose are:1)  Thick skin2)  Divergent nasal cartilages3)  Overly curved nasal cartilages4)  Wide nasal cartilage5)  Short underprojected nose6) Wide nasal bonesIn reviewing your pictures, fillers could slightly raise your bridge of your nose.  In all honesty, the changes that you are seeking would not be possible with injections.  To create a smaller more defined nose, you would need to undergo a rhinoplasty.I certainly understand your concerns undergoing surgery.  I have been involved with many African American rhinoplasties and I have never seen a keloid secondary from the surgery.  I would love to hear the input from other doctors that answer this question if they have ever seen a keloid after a rhinoplasty. I hope this helps.

Michael T. Somenek, MD · Answer

I do not recommend fillers for your nose. If you want your nose to be narrowed, you would most benefit from a rhinoplasty. Techniques that would help achieve the result you are looking for include nasal tip refinement and alar wedge excisions to narrow the nostrils.  Even individuals who keloid have good results when it comes to rhinoplasty and frequently don't see that extent of keloid formation in the nose.Fillers that are placed in the nose carry their own risks. Because they are being injected into a small space, the filler can cause compression of the blood vessels that supply the skin which can lead to necrosis of the overlying skin envelope in the nose. That being said, some fillers can be used but it should be by someone who is experienced in doing so and knows how to diagnose and treat a problem early to avoid a larger problem.

Kofi Boahene, MD · Answer

In general everyone  wants the least invasive ways of achieving results . In the end, a good result is the ultimate goal.currently available fillers are temporary means of injecting volume into an area where there is lack of volume. In the nose, fillers  can temporary raise the nasal skin and provide some definition.fillers however have drawbacks. They cannot be precisely contoured. In heavy skinned noses, they are not very effective  . In the tip they can be a source of infection a concept in rhinoplasty is creating definition by contrasting highlighted areas with shadows. While fillers are ok in  raising and creating highlights they cannot effectively  create contrasting  shadow areas and can leave the nose looking more bulbous and ill- defined specifically about  your case, you seem to have a nice defined bridge on front view . Creating a tip to match will bring the entire nose into proportions . When you smile, the tip and nostrils widens and you loose all definition making the nose less photogenic . Concentrating on these areas rather than focusing on a high thin bridge alone will make an overall nice nose.a brief answer to tour question..... Fillers will not be my recommendation.

William Portuese, MD · Answer

Close rhinoplasty techniques can completely  alleviate  the potential for keloid formation, since all the incisions are placed on the inside of the nose. We do not recommend fillers placed in the nose since they're   adding more bulk to the nose on a temporary basis. A surgical rhinoplasty through closed techniques could narrow the tip with suture techniques applied to the lower lateral cartilages, osteotomies of the nasal bones can  narrow the bridge line and a cartilage graft can be placed along the top of the bridge line to give added height.

Darryl J. Blinski, MD · Answer

If keloid former than even filler injections on the nose could potentially form a keloid from the injection point..

Inessa Fishman, MD · Answer

Fillers are plumping agents which add volume; they can be used to add height and disguise indentations and bumps.  Although they can create the illusion of added narrowness by adding height, fillers cannot make narrower a wide nose, especially the widened nostrils.  Flared nostrils or a bulbous tip can be improved within a rhinoplasty procedures.  Thankfully, the central face and the nose seem to be spared from keloid formation.  While it is a possibility, I have not seen rhinoplasty-related keloid formation in my practice and have heard other rhinoplasty surgeons discuss the absence of rhinoplasty keloiding in their practice at meetings.  A review of the rhinoplasty literature describes a few hypertrophic scars in African-American rhinoplasty patients, but no keloids.  You would be best served by an in-person consultation and exam with an experienced rhinoplasty surgeon.  Such a person is usually a Facial Plastic Surgeon or General Plastic Surgeon who performs many, many rhinoplasties, and has a keen understanding of both nasal anatomy and physiology.  An exam and consultation will help you formulate an effective treatment plan and review your treatment options.  Good luck!

Will Nose Fillers help my African American Nose? Ethnic/African American Rhinoplasty. (Photo)

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