J Cosmet Med.  2020 Jun;4(1):41-45. 10.25056/JCM.2020.4.1.41.

A case of temporary correction of drooping nose due to postoperative descent of silicone implant using a filler injection

• Kang K
• Kim MH
• Byeon HS

• KMID: 2561092
• DOI: http://doi.org/10.25056/JCM.2020.4.1.41

Abstract

Drooping of the nasal tip is one of the main complications of rhinoplasty. Herein we describe the case of a 42-year-old female who underwent simple augmentation rhinoplasty using an I-shaped silicone implant approximately 3 years ago visited our clinic for the correction of a drooping nose. The contour of the I-shaped silicone was observed in the dorsum of the nasal skin above the supra-tip break point, which caused the nasal tip to droop. The patient refused revision rhinoplasty and requested to temporarily correct the drooping nose using a noninvasive procedure. Sequential augmentation of filler injection (SAFI) for rotation, projection, and augmentation was recommended to correct the condition. In total, 0.6 ml of hyaluronic acid (HA) filler was first injected into the dead space between the anterior nasal spine and end of the medial crus of the lower lateral cartilage and columella for tip rotation. It was then placed intranasally on top of the middle crus of the lower lateral cartilage for tip projection (0.2 ml). Finally, it was injected into the upper lateral cartilage around the supra-tip break for dorsal augmentation (0.4 ml). A total of 1.2 ml of filler was injected. After 2 weeks, 0.2 ml of HA filler was injected for tip rotation. After 4 months, a postoperative follow-up study was performed. The nasolabial angle had changed from 90° to 105°. Tip projection was significantly increased. The abnormal contour of the silicone implant in the dorsum was no longer visible. The drooping nose remarkably improved with the sequential combination of rotation, projection, and augmentation using the SAFI technique, which considers the dynamic structure of the nasal tip. We were able to demonstrate that the SAFI technique can be a reliable technique for filler rhinoplasty.

Keyword

drooping nose; filler injection for nose; projection; rhinoplasty; rotation