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.

15 Responses to Are Fillers Safe After Rhinoplasty?

    • Hi Monica – Thank you for checking out our blog. Nonsurgical rhinoplasty uses filler to shape and define the nose. Typically, results last 9-12 months. We recommend touch-ups yearly to keep your results looking fresh. Without maintenance, the results will gradually fade overtime. You can learn more about nonsurgical rhinoplasty on our website where we feature an extensive before/after photo gallery of our patient results, as well as treatment videos. If you have additional questions or if you would like to know if you’re a candidate for nonsurgical rhinoplasty, give us a call. We’re happy to assist you.

  • Sheryl says:

    I don’t care for the idea of having to get periodic touch-ups. Do you ever use permanent fillers like bellafill for this treatment?

    • Dr. David Mabrie says:

      Hi Sheryl ~ Thank you for checking-out our blog and your question. Nonsurgical rhinoplasty is a great way to shape and define the appearance of the nose without surgery. While the procedure has gained popularity in recent years, it is not without risks. If you are considering nonsurgical rhinoplasty is important to find a skilled, experience Injector familiar with nasal anatomy. Nonsurgical rhinoplasty is a technically challenging procedure and in the hands of a skilled Injector can highlight and contour the nose. I prefer to use a hyaluronic acid (HA) based filler, often Restylane, for the nose because of its consistency. It provides excellent lift and projection for the area. I also prefer to use a dissolvable filler for patient safety and aesthetics. If, for any reason, we aren’t happy with the results, the filler can be dissolved with the use of hyaluronidase. Bellafill, while semi-permanent, cannot be dissolved and also requires periodic touch-ups. Based on the risk/benefits of both fillers, I prefer to use the HA. After your initial treatment, maintenance at 9-12 month intervals to keep your results looking fresh. I hope that helps!

    • Hi Sheryl ~ Thank you for submitting you question about nonsurgical rhinoplasty and permanent filler. I prefer to use a hyaluronic acid based filler (like Restylane) because of its consistency and reversibility. Reversible fillers are important for patient safety and satisfaction. If, for any reason, we are unhappy with the results we can dissolve it. While Bellafill is a longer-lasting filler, it is not reversible and does require touch-up. Nonsurgical rhinoplasty results can last up to 1 year with yearly touch-ups recommended to keep your results looking fresh.

  • Marcie says:

    Would massaging the filler into the nose where there is a dent/depression not cause further problems? (ie. more of a sunken appearance once the filler wears off and/or pushing the filler substance down and creating breathing problems?)

    • Hi Marcie ~ Thank you for checking out our blog and submitting this great question. Massaging the filler after nonsurgical rhinoplasty will not cause the filler to move or create a dent/depression. You can wear glasses, sleep naturally, and continue daily activities after treatment. Filler placement occurs under the skin and does not alter the anatomy; therefore, will not cause breathing problems. We recommend yearly maintenance treatments to keep your results looking their best.

  • Trisha To says:

    Hi Dr,
    I’ve filler for 7 months, but I’m going to do surgery for the rhinoplasty on next July. However, the filler still present, can I do dissolve it?
    Thank you,

    • Hi Trisha – Thank you for your question about dissolving nonsurgical rhinoplasty fillers. Depending on the filler used, dissolving before your surgical procedure is possible. Hyaluronic Acid (HA) based fillers, like Restylane or Juvederm can be dissolved by injecting an enzyme (Hyaluronidase) to areas where the fillers are placed. This enzyme dissolves the filler to water that is absorbed into the body within 24-48 hours after application. Fillers that are not HA-based (Radiesse, Bellafill) cannot be dissolved. In my practice, we only use HA-based filler for nonsurgical rhinoplasty. I hope that helps and best wishes for your surgery.

  • taiba says:

    I recently went under a rhinoplasty in December 2018 and the results aren’t what I hoped for. there are some minor irregularities that I would like fixed with filler around July/ August 2019 time. is that enough time or would I need to wait for a longer period before getting fillers?

  • elizabeth bullock says:

    HI
    I HAD RHINOPLASTY WITH ENT SURGEON FREE ON NHS THIRTY FIVE YEARS AGO, WHICH SEEMED LIKE A GOOD IDEA AT THE TIME. IT WASNT> RUBBISH RESULT, REVISION A YEAR LATER, STILL RUBBISH IF NOT WORSE, ESPECIALLY ONE SIDE, FAST FORWARD 20 YEARS , AN ENT SURGEON WHO IWAS SEING FOR SOMETHING ELSE COMMENTED THAT HE COULD FIX THE PROBLEMS I HATED, A WATSE OF TIME.MY NOSE LOOKS ENORMOUSLY BEAKY FROM ONE SIDE ESPECIALLY.i WAS EXSTATIC WHEN I DISCOVERED THE NON SURGICAL NOSE JOB, BUT NOW DISAPPOINTED TO READ , IT MAY BE MORE CVOMPLEX HAVING IT, IF THE PATIENT HAS HAD RHINOPLASTIES ALREADY. ITHOUGHT FOR ME I WOULD BE COMPROMISED. i LIVE IN UK LANCASHIRE, CAN YOU RECOMMEND AN EXPERT , AND IS IT RISKY AFTER ALL THIS TIME?

    • Hi Elizabeth ~ Thank you for sharing your experience with surgical rhinoplasty. I’m sorry to hear that you’re unhappy with the results after revision. Nonsurgical rhinoplasty could be an option even after revision surgery. Your Injector will let you know whether you’re a good candidate for the procedure. If you like, you can send in some photos for a Virtual Assessment, but keep in-mind that the best course is to meet with an experienced Injector in an office setting. Many of my patients travel from the UK for treatment. I’d be happy to schedule some time for us to meet.

  • Anna says:

    Dear Dr. Mabrie,
    After a revision open rhinoplasty (for excess columellar show), I now have a retracted columella — which is substantially higher than my alar margin. Can filler be used in the columella after open rhinoplasty? Can it also be used in the nostrils? If it’s possible to use dermal fillers in those areas, how many months or years after the revision rhinoplasty can filler be safely used in the columella or nostrils? (My initial rhinoplasty was a closed procedure, 21 years ago.)
    Thanks very much for your guidance!

    • Hi Anna – thank you for checking out our blog about Fillers After Surgical Rhinoplasty and your questions. Fillers can be used in the columella and nostrils after surgical rhinoplasty. I suggest waiting about 4-6 months post-operative before making a filler appointment. When searching for an Injector, it is important to find an Expert Injector with experience performing nonsurgical rhinoplasty after surgery. I cannot stress this enough. Nonsurgical rhinoplasty is an anatomically challenging area. When adding altered anatomy from surgery, it is even more critical for the procedure to be performed by someone familiar with nasal anatomy and injecting. If you’re in the San Francisco Bay Area or plan to travel here, please give our office a call. I am happy to help you. I hope that helps.

  • Bee says:

    I have the exact same problem after a revision rhinoplasty.
    I have a dent in the tip of my nose and retracted collumella.
    I am wondering of tgis can be improved with fillers.

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