Q. I’m no longer interested in procedures and am thinking about rhinoplasty. Is it possible to have nose surgery even if I’ve had Hi코 or filler?

Hello! This is AB Plastic Surgery Clinic.

Today, we’ll talk about whether nose surgery is possible after procedures such as Hi코 or filler.

The answer is yes!

In fact, among many of the patients who come in for consultations, a large number have previously had various procedures. Typical examples include filler or Hi코, and in rare cases, permanent fillers such as Artecoll, as well as nose botox.

First, the advantage of trying a procedure is:

Depending on the case, you can get used to the nose shape after surgery in advance, which can help you judge whether rhinoplasty suits you.

However, there are a few things to be careful about when doing it.

First, with fillers, many people have the procedure done multiple times. Most people think they can simply dissolve them later before surgery, but in some cases, fillers that were placed years ago may not dissolve easily. Also, sometimes the filler spreads sideways and ends up making the nose look wider. The biggest issue is that, in the case of nose fillers, there is a rare risk of complications such as blindness, so caution is needed.

Among these fillers, some people come in with permanent fillers such as Artecoll rather than hyaluronic acid fillers. These must be removed during surgery, and in some cases, removal can be difficult. Also, if they have been injected extensively into the nose, they can distort major structures and negatively affect the postoperative shape. If the filler is old and does not dissolve, it can cause unevenness of the nasal bridge skin after surgery. And, although rare, it can become a cause of infection after nose surgery.

In the case of threads such as Hi코, they are used to raise the nasal bridge and tip overall, or to lift the tip by inserting them into the columella. However, the amount by which they lift the tip is not very large. The threads commonly used often dissolve after 1–2 years. In some cases, complications such as a foreign-body sensation or visibility through the skin may occur. These threads are removed if found during surgery, but if the thread is located too close to the skin, removing it can damage the skin or create surface irregularities, making complete removal difficult in some cases. Also, if threads have been in place for a long time, they can damage the surrounding normal anatomy and make surgery more difficult.

As mentioned above, I said these procedures can help predict the postoperative shape, but that does not apply to everyone. Recently, the height of the nasal tip has become more important than the height between the eyebrows, so it is difficult to create a nose with a well-supported tip or an overall attractive shape through procedures alone. For example, if the nose is large, has a hump, and the tip droops, using filler or threads can actually make the nose look even larger. Also, in the case of a severe bulbous tip, tissue at the tip needs to be reduced, but if filler is used, the amount of tissue may increase instead, which can make the bulbous tip worse.