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Facial Plast Surg
DOI: 10.1055/a-2764-3235
Original Article

Surgical Management of Filler Rhinoplasty Complications

Authors

  • Eugene H. C. Wong 

    1   Department of Otorhinolaryngology, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia

  • Alwyn D'Souza

    2   Institute of Medical Sciences, Canterbury Christchurch University, Kent, United Kingdom
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Abstract

Aim and Background

The increasing use of filler rhinoplasty has led to more patients presenting with complications such as fibrosis, granuloma formation, skin irregularities, and filler migration, including the characteristic “Avatar nose.” These cases require a systematic, algorithm-driven approach for safe and predictable correction.

Historical Aspects

Nonsurgical rhinoplasty has gained popularity due to its minimally invasive nature, yet complications requiring surgery have become increasingly recognized.

Anatomy

Distorted soft-tissue planes and altered skin-soft-tissue envelopes (SSTE) after filler placement influence both dissection and reconstruction.

Technology

High-frequency ultrasound can assist in identifying residual filler and guiding hyaluronidase dissolution before surgery.

Patient Selection

Patients with persistent deformity, migration, granuloma, or long-standing fillers unresponsive to nonsurgical measures are appropriate surgical candidates.

Techniques

Revision rhinoplasty involves open approaches, selective removal of residual filler, and structural reconstruction with autologous cartilage. Redundant SSTE may require increased dorsal augmentation, conservative trimming, and adjunctive intraoperative doxycycline.

Postoperative Care

Postoperative corticosteroid injections can limit fibrosis and improve contour.

Current and Future Development

Algorithm-based evaluation and operative planning continue to refine management of these complex cases.

Conclusion and Clinical Relevance

Thoughtful surgical execution is essential for achieving stable, natural outcomes in patients with filler-related nasal complications.

Keywords

filler rhinoplasty - revision rhinoplasty - avatar nose - hyaluronidase

Declaration of GenAI Use

During the writing of this article, the authors used ChatGPT to correct spelling, refine grammar, and format the text. The authors have reviewed and edited the content and take full responsibility for the final version of the article.




Publication History

Received: 19 November 2025

Accepted: 03 December 2025

Article published online:
18 December 2025

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