Can I Get Injectable Fillers Into My Nose After Having Had A Rhinoplasty?

Q: Dr. Eppley, Hi, I’m interested in using filler to augment my low nasal bridge and droopy, bulbous tip, but the problem is I have had 4 unsuccessful nose surgeries, and am not sure if filler can help. My concern is that my nose was built using rib cartliage and I know how the skin tends to exert a lot of force on the cartliage, so I’m not sure if my nose condition is ideal for filler, especially on the nasal tip. How do you go about and evaluate if my nose condition is ideal for using filler? Thanks!

A: With four prior rhinoplasties and a rib graft in place, I would be very concerned about the risk of skin necrosis with any injectable material. Between the scar tissue and the push of the rib graft underneath, you do not have normal flexible and distensible nasal skin. More relevantly the blood supply to the skin, particularly in the tip area, has been affected by all of these surgeries. Any additional pressure exerted by an injectable filler may tip the balance in the nasal tip to one of vascular compromise. You are far safer in the bridge area with injectable fillers where there is a more robust blood supply that is not on an island so to speak. Even putting it there I would be cautious about doing too much filler at one time.

Dr. Barry Eppley

Indianapolis, Indiana