Nasal Filling in Plastic Surgery Practice: Primary Nasal Filling, Nasal Filling for Post-rhinoplasty Defects, Rhinoplasty After Hyaluronidase Injection in Dissatisfied Nasal Filling Patients

Bektas G, Cinpolat A, Rizvanovic Z.

What this paper says

Across 62 primary filler patients, 18 treated for post-rhinoplasty defects, and 5 who had filler dissolved before surgery, no filler residue or complications were found at rhinoplasty performed as little as one week after dissolving.

Overview

Hyaluronic acid filler can be dissolved with hyaluronidase if a patient dislikes the result and wants surgery instead, but no publication states how long to wait before operating. This case series reports the authors' experience across three groups, including five patients operated at different intervals after dissolving.

Sections of note

Patients treated from July 2015 to March 2020 were analyzed in three groups.
Group a: 62 patients receiving primary nasal filling.
Group b: 18 patients receiving filling for post-rhinoplasty defects.
Group c: 5 dissatisfied patients who had rhinoplasty after hyaluronidase injection, at intervals of 6 months, 3 months, 3 months, 2 months and 1 week.
Group a results: 57 fully satisfied, 2 satisfied, 3 dissatisfied; results stable at least 6 months, range 6 to 14 months.
Group b results: all fully satisfied; results stable at least 12 months, range 12 to 36 months.
Group c results: no filler residue observed, no complications, satisfactory postoperative results. Level of evidence IV.

What it means for a patient

Filler used to smooth irregularities after rhinoplasty lasted notably longer than filler used in an unoperated nose, at least 12 months versus at least 6.
If you dislike a filler result, it can be dissolved and surgery performed afterward.
Based on 5 patients, the authors suggest surgery can be done at least one week after dissolving.
Limits: 5 patients in the group answering the paper's central question, no comparison group, and no objective assessment of residual filler.

Why this paper matters

The waiting interval between dissolving filler and operating had no published guidance, and this is the first attempt at one. Five cases is a very small basis for a timing recommendation. The finding that filler lasts longer in operated noses is a useful secondary observation.

Terms

Nasal filling: Injecting filler to reshape the nose without surgery.
Hyaluronic acid: A filler material that can be dissolved with an enzyme.
Hyaluronidase: The enzyme used to dissolve hyaluronic acid filler.
Post-rhinoplasty defect: An irregularity remaining after nose surgery.
Case series: A report on a group of patients with no comparison group.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Nasal filling has gained popularity in plastic surgery practice and strengthened the surgeon's hand. Mild deformities of the nose can be treated with nasal filling instead of rhinoplasty, or small contour irregularities following surgical rhinoplasty can be corrected by dermal filler injections. It is a significant…”

Excerpt; the full abstract is on PubMed.