How to remove filler and threads injected into the nose and reconstruct the structure

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce a case of a patient who chose surgical correction for a better outcome after undergoing thread and filler procedures.

Through this case, I will explain in detail the limitations of non-surgical procedures, the advantages of surgical correction, and the effects of closed rhinoplasty.

A patient with this presentation visited our clinic with the following concerns:

• General satisfaction with the overall nasal shape, but lingering areas of disappointment

• Correction of a blunt, bulbous nose appearance

• Improvement of areas that appeared crooked

• A preference for a nasal shape that matches overall facial proportions

Preoperative consultation: thorough analysis and personalized design

During the pre-operative consultation, close observation of the patient's face and nose revealed the following characteristics:

• Although the overall shape was acceptable due to the threads and filler, there was a blunt and crooked appearance

• Asymmetry of the nose and an irregular surface along the nasal bridge were observed

• The nasal tip appeared slightly drooping

• The chin was small, giving the impression of a receding chin

To address these issues, the following surgical plan was established:

• Septal extension using autologous rib cartilage was planned. This procedure improves the blunt appearance of the nasal tip and secures nasal stability

• Lower lateral cartilage repositioning and cartilage suturing to naturally correct the bulbous nose appearance and improve nostril asymmetry

• Complete removal of the existing filler and threads from the nasal bridge, followed by silicone implant placement to correct the crooked nose

• Placement of an approximately 6 mm silicone implant at the chin via an intraoral approach to correct the receding chin

Surgical process: maximizing the benefits of a closed approach

I perform all rhinoplasty procedures, including revision surgeries, using a closed approach. In this case as well, the closed technique offered the following advantages:

• Minimized post-operative swelling and recovery period

• No external incision scar on the columella

• Enables a more meticulous procedure

• Surgical results can be evaluated immediately after surgery

The most crucial part of the surgery was removing the existing threads and filler safely and thoroughly. This is a very delicate process, requiring complete removal of foreign materials while minimizing trauma to surrounding tissues. Utilizing the benefits of a closed approach, this was accomplished through minimal incisions.

To support the stability of the nasal tip, septal extension using autologous rib cartilage was performed. This is an essential step that refines the tip shape and provides long-term stability. To correct the deviation of the nasal bridge, a silicone implant was positioned directly along the midline, and nostril asymmetry was improved through cartilage repositioning and cartilage suturing.

Additionally, to balance the chin profile, a 6 mm silicone implant was placed at the tip of the chin.

Analysis of results immediately after surgery (day 0) Immediate post-operative photos show swelling and may differ from the final result.

Comparing the photos taken immediately after surgery on day 0 with the pre-operative photos shows the following changes: Immediate post-operative photos show swelling and may differ from the final result.

• The overall profile of the nose became smooth with a straight bridge line, resulting in a very natural look

• The previously blunt nasal tip was refined, creating a more sophisticated impression

• The crooked-looking nasal bridge was straightened

• Nostril asymmetry was improved, yielding a better balanced appearance

• Overall facial balance improved due to the chin implant

Of particular note, the surface irregularities, bluntness, and asymmetry caused by the threads and filler were thoroughly corrected, achieving a much more natural and harmonious shape.

Surgical summary: successful correction overcoming the limitations of non-surgical procedures

This case illustrates the limitations of non-surgical treatments such as threads and filler, while highlighting the advantages of surgical correction. By utilizing a closed rhinoplasty approach, minimal scarring and a swift recovery were supported, while allowing refined correction tailored to the patient's overall facial proportions and harmony. Although thread and filler procedures can provide temporary cosmetic improvement, maintaining a stable result over the long term is difficult. In particular, subtle modifications of the nasal tip or correction of a crooked nose often require a surgical approach. In cases of this type, surgical intervention can overcome these limitations and achieve a more favorable outcome.

Closing remarks: advice for those considering their options

I hope this case is helpful to those who have undergone thread or filler procedures but remain dissatisfied, as well as to those considering rhinoplasty. While simple procedures such as fillers or threads may create a temporarily pleasing nasal shape, maintaining that appearance semi-permanently is not possible, and changes in shape over time are unavoidable. In particular, altering the shape of the nasal tip is practically impossible with threads or filler, and there are risks of severe and irreversible complications such as skin necrosis or blindness. Therefore, I advise regarding threads and filler merely as a way to get a sense of bridge height changes, and keeping in mind that substantial nasal reshaping must be accomplished through nasal surgery.

If you are considering rhinoplasty, I recommend consulting with a rhinoplasty specialist to determine the method most suitable for you. I am always here to help you achieve a well-planned and satisfactory result.

This was Dr. Peter C. Kang. Thank you.

Thank you.

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