Is safe to get fIller in the pyriform aperture region before revision rhinoplasty?

Question

I’m interested in getting filler in the Pyriform aperture to rejuvenate my midface and nasolabiel folds however I’m getting a revision rhinoplasty in 3 months. Should I wait until after the surgery or is it safe to do it now? Is there a higher risk of infection?

Randal Haworth, MD, FACS · Answer

Getting filler injections in the Pyriform aperture or any facial area prior to a revision rhinoplasty could potentially affect the surgical procedure and the healing process. The filler may interfere with the surgical site, making it more challenging for the surgeon to perform the revision rhinoplasty and achieve the desired results.

I hope this helps,
best of luck !

I hope this helps,
best of luck !

Yucel Sarialtin, MD · Answer

Hello,
It's generally recommended to wait until after your revision rhinoplasty before getting filler in the pyriform aperture, especially since that area is anatomically close to the surgical site. Getting filler beforehand could interfere with surgical planning, affect post-op swelling, or increase the risk of complications like infection or altered healing. While the infection risk from filler is low in healthy individuals, any foreign substance (like filler) near a surgical site can potentially complicate healing or increase inflammation. To ensure optimal results and safety, it's best to consult with both your rhinoplasty surgeon and an experienced injector to coordinate timing&mdash;but in most cases, waiting until after the nose has healed is the safer choice.

Jeffrey M. Darrow, MD · Answer

A revision rhinoplasty can be a very nuanced procedure. Exactly what would be done in your revision rhinoplasty is unknown, and therefore, it is always my position to minimize the variables that could potentially affect your surgery. The fillers placed in your pyriform aperture may slightly alter the appearance of your nose, and what is performed at your revision rhinoplasty, so not having that variable to deal with would be in your best interest.  The fillers can always be placed at a later date, but getting your nose as close to what you want would be paramount. Best wishes.

Oakley Smith, MD, FRCSC · Answer

Hi, It is better for you to consult with your facial plastic surgeon who can examine you and give you opinion based on examination. It's safe.

Ali Sajjadian, MD, FACS · Answer

Thanks maysale12 for your question! Filler may occasionally make rhinoplasty more difficult if it is not fully absorbed or dissolved before to the procedure.  
This is the reason:
-Tissue Distortion: The surgeon may find it challenging to precisely evaluate the underlying structures and arrange the surgery if filler causes the underlying tissue to become distorted.
-Increased Complication Risk: Filler may make surgical problems like bleeding or infection more likely.
-Restricted Effects: Filler can only add volume and fix little flaws. Significant structural problems like a humped nose or a deviated nose cannot be fixed by it.   
Therefore, it's usually best to put off thinking about filler procedures until after your rhinoplasty has completely healed. This will enable your surgeon to work with your nose's natural curves and get the greatest outcomes. Sometimes the filler can be dissolved with an enzyme called Hyaluronidase. 
It's important to consult with a board-certified plastic surgeon to discuss your specific needs and concerns. They can provide personalized advice based on your individual situation and help you make informed decisions.
Hope this was helpful!
Best wishes,
Dr Ali Sajjadian 
TRIPLE Board Certified Plastic Surgeon

Eric M. Joseph, MD · Answer

Many of our patients have injectable fillers in their cheeks before rhinoplasty surgery, and we have not seen an issue with any of them. I hope this answers your question! Sincerely, Dr Joseph

Gianfranco Frojo, MD · Answer

I highly recommend against doing any filler in the face in general, especially prior to surgery. The filer is highly unpredictable after surgery as it may swell severely and cause prolonged edema in the area.

Ryan Rebowe, MD · Answer

Overall this would be very safe to perform. However, it may affect surgical planning depending on what needs to be done in the rhinoplasty revision. I would ensure that your surgeon knows that you are getting this injection done prior to completing the revision rhinoplasty.

Cory Bovenzi, MD · Answer

It would be best to wait until after you are healed from surgery to get filler in the pyriform aperture. The biggest risk is to the vascular structures in the area

Bianca Knoll, MD · Answer

thank you for posting your question. It would be my suggestion to refrain from filler injections at the piriform aperture. The effect might get lost, and what looked good 3 month before your surgery, may not be the best fit after your revision rhinoplasty. Instead I would suggest to discuss with your surgeon if there is the possibility to use some of the cartiladge that might be used for your revision, to build up the piriform aperture. This is commonly done, especially if there is a height asymmetry between the 2 alar bases.  Requirement is a certain amount of redundant cartilage, which is usually not the problem especially if rib grafts are used for your revision. An alternate might be the so-called "turkish delight" were little pieces of cartilage are encompassed by PRF and/or fascia. I hope this was helpful.

Emmanuel De La Cruz, MD · Answer

Injecting dermal fillers in the pyriform aperture region or any area of the face before revision rhinoplasty should be approached with caution, and it's essential to consult with a qualified and experienced facial plastic surgeon or dermatologist. While fillers can be used to address certain aesthetic concerns, there are several important considerations to keep in mind:

Anatomical Knowledge:

The pyriform aperture is a bony structure at the base of the nose. It's crucial for the injector to have a thorough understanding of facial anatomy to avoid potential complications.
Consultation with a Specialist:

Schedule a consultation with a facial plastic surgeon or dermatologist who has expertise in both nonsurgical and surgical facial procedures. They can assess your specific concerns, the need for revision rhinoplasty, and the appropriateness of fillers in the pyriform aperture region.
Timing Considerations:

Depending on the planned revision rhinoplasty, it may be advisable to wait until after the surgical procedure before considering fillers. The surgeon can provide guidance on the optimal timing for any nonsurgical enhancements.
Potential for Interference:

Fillers in the pyriform aperture region could potentially interfere with the surgical process during a revision rhinoplasty. The surgeon will want a clear and unaltered view of the anatomy during the procedure.
Individual Assessment:

Each individual's anatomy and aesthetic concerns are unique. A personalized assessment is essential to determine the most appropriate approach to achieving the desired results.
Communication with Your Surgeon:

If you already have a surgeon for your revision rhinoplasty, discuss your interest in fillers with them. They can provide guidance based on your specific case and overall treatment plan.
It's important to emphasize that any injectable procedure, including the use of fillers, should be performed by a qualified and experienced medical professional in a clinical setting. Always prioritize safety and seek a thorough consultation to ensure that the chosen treatments align with your overall facial aesthetic goals and surgical plans.

Remember that individual responses to treatments can vary, and the appropriateness of combining fillers with revision rhinoplasty will depend on various factors specific to your case.

Is safe to get fIller in the pyriform aperture region before revision rhinoplasty?

Answers (21)

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