Is this swelling or filler migration? (Photo)

Question

I got filler to the tip of my nose and cheekbones about 3 months ago. Right away the left side of my nose (sinus area) and left side of the tip of my nose were very swollen. My injector said it was just swelling and should go away. ...3 months later my face is still very uneven. The 1st picture is before, 2nd is immediately after injection. You can see the left side of my nose tip and sinus is swollen. The other pictures are from today. It is still swollen and off. What is this???

Raffy Karamanoukian, MD, FACS · Answer

You may be correct to detect the swelling from the HA filler. If you don't like the swelling, then you may be a candidate for HA reversal with Hylenex.

Dr. Karamanoukian
Realself100 Surgeon

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. Swelling after filler injection is common but should be resolved within three months. If there is still asymmetry or issues after three months, I would suggest dissolving the product with Hyaluronidase. Find a qualified provider, injections into the nose should not be taken lightly as they can be high risk. Pre-injection ultrasound evaluation would be very helpful.
Good luck!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

James M. Economides, MD, FACS · Answer

From your photos it appears that filler has either been placed or has migrated to an inappropriate location. The nose is a very challenging area to inject properly with many important and delicate deep structures and vessels. It is very important to only allow a very experienced injector place filler in this area. I regularly see patients who require revision of this area. It would be best to dissolve the filler or let it reabsorb prior to reinjecting to allow for a clean slate.

Daniel Urias, MD · Answer

Based on the photos and the treated area (nose tip), that looks like filler. Likely you will need the other side reinjected or dissolve the side with filler. HA filler is a gel and can always be molded to some extent. Another option would be to massage the area that has the filler to make more flat, this will hopefully make it less noticeable but careful as too much manipulation can create an inflammatory reaction, scar tissue or encapsulate the filler. The safest but least aesthetically pleasing is let it absorb on its own.

Camille Cash, MD · Answer

Your photos show you have a deviated septum.  The addition of volume from the filler may be enhancing the appearance.  If HA filler was used it can be dissolved using hyaluronidase.

Darryl J. Blinski, MD · Answer

Your series of posted are not very helpful in that appears you have a severely deviated septum. Best to be examination in person nasal examination..

Is this swelling or filler migration? (Photo)

Answers (6)

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