Revision Rhinoplasty With or Without Surgery

When you consult for revision rhinoplasty, understand there are quite a few options available to you. First, not the entire rhinoplasty operation needs to be repeated. Often, just a portion of the nose needs attention. In some patients, improvements can be obtained without another trip to the operating room. Some "bumps" or "rises" can be permanently flattened by shrinking the soft tissue underneath the skin. This is done through a series of injections that are typically scheduled four weeks apart – which effectively shrink the fat-like tissue underneath the skin and can permanently erase the mogul or irregularity.

In the opposite situation, where there is a dip, depression, groove or hollow, that can be filled, permanently, with a series of injections but using a different material. The only material that has lifetime benefit is medical grade liquid silicone. Medical grade liquid silicone which is an FDA approved product (approved for use inside the eyeballs, so you can understand how safe it is) is injected underneath the skin to fill the defect.

Both injections are done in the office using magnification. The skin is made numb to make the injection virtually painless, using an anesthetic cream.

For those patients requiring revisional rhinoplasty because of nasal obstruction, due to either deviated septum or enlarged turbinates, there isn’t an alternative to surgery. No injections can cure the architectural problem.


— Robert Kotler, MD, FACS