Are Fillers Safe After Rhinoplasty?

Nonsurgical rhinoplasty to widen the bridge

The Truth About Nonsurgical Rhinoplasty After Surgery

I recently posted to my Instagram account a patient’s before-and-after photographs showing a nonsurgical revision rhinoplasty using fillers. The San Francisco patient wasn’t happy with her surgical rhinoplasty that was performed by another doctor. She felt that the tip of her nose appeared “pinched” and the angles a bit exaggerated. She visited my office to see if we could improve the appearance by creating more natural, healthy-looking contours. It took 3 separate treatments spread out over about a year, but the results were worth it.

One of the commenters on that post said most surgeons recommended not to get fillers after having rhinoplasty surgery and asked how I was able to “work around” the issue. In this post, I’d like to share my response and emphasize the importance of choosing a highly trained and experienced surgeon to perform nonsurgical revision rhinoplasty.

Nonsurgical rhinoplasty before-and-after from 2 perspectives
Nonsurgical rhinoplasty before-and-after from the profile view Nonsurgical rhinoplasty before-and-after from the side view.

Is Nonsurgical Revision Rhinoplasty a Better Choice Than Revision Rhinoplasty Surgery?

Some patients are unsatisfied with the appearance of their nose after surgical rhinoplasty, but are hesitant to undergo a second revision surgery. Fortunately, nonsurgical revision with filler can be a safe alternative with excellent outcomes for a couple of reasons.

Less Risk

Revision rhinoplasty surgery can be more difficult and costly than the initial surgery because of the higher medical risk.  After the initial surgery there can be irregular scar tissue, changes in anatomy, as well as compromised blood flow/poor skin conditions, adding additional challenges to surgery.

Nonsurgical rhinoplasty before-and-after from 3 perspectivesNonsurgical rhinoplasty before-and-after from front view.Nonsurgical rhinoplasty before-and-after from oblique view.Nonsurgical rhinoplasty before-and-after from side view.
Shorter Recovery

Patients can be concerned about undergoing general anesthesia and a long recovery process where it could take an additional 6 to 9 months for final results to be visible.

Rhinoplasty surgery is great for making big changes, but not as effective with smaller refinements. Swelling onset during surgery can make predicting outcomes challenging.  What looks good in the operating room may change over time during the healing process.  Millimeters can make a big difference! Fortunately, nonsurgical revision rhinoplasty with filler can be a safe alternative with excellent results and high patient satisfaction.

Nonsurgical rhinoplasty to add volume to the bridgeNonsurgical rhinoplasty to add volume to the bridge, oblique view.Nonsurgical rhinoplasty to add volume to the bridge, side view.Nonsurgical rhinoplasty to add volume to the bridge, front view.

Using Filler to Reshape the Nose: The Benefits of Nonsurgical Revision Rhinoplasty

Less Trauma = Less Risk

Revision surgery can create new trauma, new scar tissue, and the possibility of damage to the nose when performing the procedure.  The surgery is invasive whether patients are looking to make big or small modifications to their initial outcomes.  Every time you separate the skin, you are disrupting the blood supply with a possibility of weakening the structure of the nose that can cause new problems.

Fillers, on the other hand, can:

  • Address areas without disrupting the internal anatomy
  • Require no general anesthesia
  • Results are immediate

Nonsurgical rhinoplasty to smooth a nasal hump Nonsurgical rhinoplasty to smooth a nasal hump, oblique viewNonsurgical rhinoplasty to smooth a nasal hump, side view

Better for Rebuilding the Nose

Many patients that consult with me after surgical rhinoplasty elsewhere have had a lot of reduction (bone and cartilage have been removed), creating an irregular contour. The gelatinous nature of fillers makes it easier to rebuild and create a smooth contour. Using a microcannula, the application feels like painting. Fillers can be applied in a precise, controlled manner unlike using an implant (synthetic or harvesting cartilage). The gel-like substance is ideal for soft, predictable results.

Do you want to learn more about how fillers can create the nose you want? Schedule your consultation now.

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Nonsurgical rhinoplasty from 3 anglesNonsurgical rhinoplasty from side view.Nonsurgical rhinoplasty from front view.Nonsurgical rhinoplasty from , oblique view

Significantly Lower Cost

Nonsurgical revision rhinoplasty costs a fraction of surgical fees. Due to the higher risk of complication, surgical rhinoplasty revision can often be more expensive than the original surgery. Surgical rhinoplasty and revision costs can often exceed $20k.

Nonsurgical rhinoplasty before-and-afters from profile viewNonsurgical rhinoplasty before-and-after from profile viewNonsurgical rhinoplasty before-and-after from profile view

What You Should Know

Nonsurgical revision rhinoplasty is an excellent alternative to revision rhinoplasty surgery, but it is not without risks.

Bruising and swelling are common side effects; however, more serious complications can include infection, vascular occlusion (injecting into an artery), and, in rare cases, blindness. Vascular occlusion can lead to tissue necrosis and scarring. Patients with prior nasal surgery may be at increased risk for vascular compromise due to altered blood supply and scarring to the area.

When considering nonsurgical rhinoplasty, choosing an experienced, expert injector is vital to patient safety. Suspected vascular occlusion should be treated immediately by dissolving filler. Vascular occlusion can rapidly progress to tissue necrosis if not identified and treated quickly. An experienced injector should be prepared with safety protocols and the tools necessary for optimal patient safety.

In my office, we are prepared to address any adverse events and also increase safety of this procedure by:

  • Using a blunt-tip microcannula to avoid puncturing an artery
  • Avoiding high-risk, vascular areas
  • Treating areas of vascular occlusion with hyaluronidase to dissolve the filler

I do believe that getting nonsurgical rhinoplasty from the outset, for many patients, can produce even better results than surgery, which is why I’m so passionate about the procedure. It can be part of my Illumination 360° treatment process, in which I correct, define, and refine a person’s features to optimize their looks. You can learn more about the procedure in a blog post from earlier this year and see how nonsurgical rhinoplasty is part of my Your Face, Perfected approach to aesthetics.

Learn More

If you’re considering nonsurgical rhinoplasty and want to learn more about the procedure, please contact us using our online form or by calling us at (415) 322-3294.  Our Concierge Team is available to answer your questions or to schedule a time for your initial assessment with Dr. Mabrie.

Dr. David Mabrie

Dr. David Mabrie

Facial Plastic Surgeon & Founder of Mabrie Facial Institute

Dr. David Mabrie is a recognized leader, innovator, and educator in the use of dermal fillers for facial sculpting and has dedicated his practice entirely to facial rejuvenation with injectables. Years of experience led Dr. Mabrie to pioneer the Illumination 360° approach, just one of the ways Dr. Mabrie brings life to his practice’s mantra: “your face, perfected.”

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