How permanent filler alters the shape of the nose and reconstruction methods after removal

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient who visited our clinic with concerns about a nose that had become bulbous and crooked due to permanent filler. The patient wished to remove the filler while simultaneously improving the overall crooked and broadened appearance of the nose.

• Past permanent filler procedure

• Permanent filler removal

• Improvement of bulbous nasal tip

• Correction of crooked nose

• Improvement of the broadened appearance

1. Permanent filler removal

• Complete removal of permanent filler from inside the nose

• Preparing to build a new structure on a clean foundation

After permanent filler removal

2. Nasal tip correction using autologous rib cartilage

• Naturally refining the bulbous nasal tip

• A structure built for long-term stability with sturdy support

• Improvement of the broadened appearance

3. Lateral osteotomy

• Correction of deviated nasal bones

• Securing overall nasal symmetry

• Creating a straight, clean nasal bridge line

4. Custom carving of the silicone implant

• Carving the implant to match the shape of the patient's nasal bone

• Creating a natural nasal bridge height

• Achieving a line in harmony with the face

1. Frontal changes

• The crooked nose was aligned along the midline

• Refining the nasal tip that previously appeared bulbous and broadened

• An overall refined and balanced impression

2. Profile changes

• Achieving a natural nasal bridge line after filler removal

• A height tailored to the face using a custom-carved implant

• A smooth curve extending toward the nasal tip

3. Nostril changes

• Improved nostril shape as the bulbous nasal tip is refined

• A balanced nostril shape

Over time, permanent filler can cause a foreign body reaction or shift position, deforming the shape of the nose. In this case as well, the filler had caused the nose to become bulbous and deviated.

In situations like this, simply removing the filler is not enough. After thoroughly removing the filler, the compromised framework must be reconstructed anew to achieve a natural and stable result.

In this surgery, autologous rib cartilage was used to provide strong support for the nasal tip, and lateral osteotomy was performed to straighten the deviated nasal bone. For the nasal bridge, a silicone implant was delicately carved to match the patient's nasal bone structure, creating a natural height.

Removing permanent filler while completely realigning the nose is a challenging procedure, but satisfying results can be achieved with an accurate diagnosis and a systematic plan.

I hope this case is helpful to those concerned about changes in nasal shape caused by permanent filler. This was Medical Director Dr. Peter C. Kang. Thank you.

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