MY STORY OF A REVISION RHINOPLASTY NIGHTMARE AND THE DANGERS OF FILLER POST-OP:It’s been almost 5 years since having a surgery that has destroyed my life - a revision septorhinoplasty done by a well-known NYC surgeon. The goal was to correct my breathing as well as aesthetic issues including dents, asymmetry and a hanging columella. I explained what I wanted during my consultation: not a complete overhaul, just to smooth out my bumpy profile and fix my breathing. At that point though, I didn’t realize how important it is to have a physical representation of the changes you want (morph or drawing) and how it is an integral part to ensuring your vision aligns with what the surgeon deems possible given the structure of your nose and your face. In my case, my nose was over-rotated and over-shortened completely changing my face and resulting in a total loss of identity which I’ve struggled with ever since.Having said all of that, the surgery went fine medically speaking - however, a week later when I got my cast removed and the stitches taken out, there was a massive dent in my columella on the suture line. The lower half of my columella bulged out which made the indentation even more obvious. A few months later, the surgeon tried to shave the lump on the lower part of the columella but didn’t address the indentation which is really what needed to be fixed.Fast forward to nearly a year post revision, I went in for a late afternoon appointment for a minor in office procedure to have a graft put into the indentation on my columella. The doctor was running very behind that day and when he came into the room he suggested putting filler into the dent rather than doing a scar revision. I didn’t know any better, so I trusted his opinion, signed the waivers, and allowed him to inject my nose with Voluma, one of the thickest HA fillers. There were a few injection points - two or three in my columella and one in my tip where he was going to camouflage a slight irregularity as I have very thin skin which shows every lump and bump. During one injection in my columella I felt a very sharp prick and I yelped out loud - the doctor asked if I was okay and I said yes, it was a split second sharp pain and he continued. A few minutes later I looked in the mirror and while the shape of the nose looked good I did notice how pale and grey the skin was. But he sent me on my way immediately and when I got home I noticed my nose was a dusky purple hue. I sent him and his PA (a well-known cosmetic injector, by the way) photos right away and they both said it’s likely a “BRUISE”, no need to worry. I immediately went on google and within minutes I knew THIS WASN’T A BRUISE. I know what bruises look like on my skin - I get them a lot as a fair, thin-skinned person. I texted them again and was told to just be in touch if I feel any pain or notice any other changes. Well, I woke up the next morning and my nose was extremely hot and painful. The doctor told me that I could come in if I was concerned - there was no immediacy, no alarm in his tone. I went in and he dissolved half of the filler - the portion in my columella, saying the tip area was unlikely to be an issue. A day later, still in pain, I took it upon myself to go back to his office and have him dissolve the remainder of the filler. Unfortunately, it was too late, the damage had been done and could have been avoided if the filler had been dissolved when the purple coloration had become evident (literally minutes post injection). This was not a bruise, this was my tissues losing oxygen and ultimately suffocating to death, a condition called ischemia which leads to necrosis (aka tissue death). Over the next few weeks my skin sloughed off and the dead tissues were expelled from my body, coming out in pus like pimples all over the tip of my nose. My skin was raw and painful.Over time the wound healed over, but my skin never regained its thickness and is still paper thin and ischemic, meaning there is compromised blood supply because tissues had been destroyed. There is protocol for this type of complication and unfortunately other than dissolving the filler, no other steps were taken to mitigate the damage. In fact, he discouraged the use of widely employed treatments. I had no antibiotics, no topical creams, and was told NOT to do hyperbaric oxygen therapy as there was “no proof” it would work. Any surgeon in this situation should have thrown the kitchen sink at this and he didn’t.For your own reference, below is a link to an article written for Allure magazine back in 2018 which quotes several very well-known rhinoplasty experts attesting to how these kind of complications should be handled and how time is of the essence. Again, this protocol isn’t new. These complications are quite feasible especially under certain circumstances and quite frankly, I probably shouldn’t have been a candidate. After 5 procedures at that point, 2 of which were open procedures done by this surgeon in the prior 11 months, my nose was extremely vulnerable and the utmost diligence should have been employed.<a target="_blank" rel="noopener noreferrer" href="https://l.facebook.com/l.php?u=https%3A%2F%2Fwww.allure.com%2Fstory%2Fnon-surgical-nose-job%3Ffbclid%3DIwZXh0bgNhZW0CMTAAAR2QyoGNIRNLz6AuHeuLp_rxBvxEWDfkSWFkdfnhX58SSMfDArwnMoMHKSI_aem_d1PIqEiXGAN0k1c0b5wpww&amp;h=AT0sPQS8BNbuEC0ENROeYU9G_0L1SyNlwtlgbUfqowYL3ONTz1ngwffo8fluEenL4HxfWIOWEonEG7b9k5EEQyJ5lHeifHkuFuSSPzY06LQJfu9qWJeRjgK2zU1iKbdfNBoK6QMQdUj_wiUhgj7zFpeDGQ&amp;__tn__=-UK-R&amp;c[0]=AT1FUuKfnKB0aqKkLBnWKn5vMSyKu8ma23FyZ4RQVX9t-Gw9VmrUi4a01ULIncrSI10NLYBIvwDu-bzfgxFRYwnDHQhGPsld8ZW90IthgTlf5wtqPL7kUDZ2Xjrtchgwo9T218za2r8zNzbH8WoahDCL-B-zjKpoxIvnB8MyTBSNCIl7qTVRaAY2dBebC98k7P_B6JY">https://www.allure.com/story/non-surgical-nose-job</a>Fast forward nearly 4 years since the filler incident, my nose tip is constantly freezing cold and turns purple/red when it’s 80 degrees and below. I’m constantly physically uncomfortable not to mention the emotional toll this has taken on me. On top of all of that, my columella was never fixed, my nose doesn’t fit my face and I still have a deviated septum. What kills me the most is that even if I wanted to have another revision, my skin is so compromised that most surgeons won’t even consider my case as the potential for a catastrophic outcome is simply too high. My life has been forever changed because of this - because a surgeon I trusted did not take prompt action in a situation that should have been deemed an emergency. I’m telling my story not to name names, but rather as a word of caution to those seeking revisions and considering fillers as a remedy. Below are a few points I’d like to offer as a takeaway:1. Filler in a nose that has had surgery is NOT without potentially devastating consequences. There is scar tissue and an altered anatomy to consider. Vessels can be occluded or even just compressed which can lead to ischemia or necrosis.2. Filler in the tip and columella is extremely dangerous as this is a very vascular zone - occlusion of an artery here could lead to blindness or brain damage, hence the reason any tiny sign of something gone wrong is an absolute emergency.3. If you choose to proceed with filler, make sure your practitioner is willing and ready to take all measurements to mitigate the damage immediately. This includes and is not limited to dissolving the filler and utilizing corticosteroids, aspirin, antibiotics, and hyperbaric oxygen therapy (which should NOT be at the cost of the patient!). Treating occlusion is a multi-pronged approach and all possible remedies should be implemented in order to have the best outcome possible. Any practitioner who does not know about or employ ALL treatment methods in an emergency shouldn’t be performing this procedure to begin with.I will say my surgeon has always been very responsive with me. I cannot say he has been dismissive of my concerns or inattentive. However, this doesn’t negate the fact that he caused a permanent issue unnecessarily and that’s not something to be overlooked. Not to mention the fact that if I hadn’t been diligent and proactive myself, the outcome could’ve been absolutely catastrophic. It is extremely important for other people to know the consequences of putting your trust in someone who very clearly demonstrated poor judgment time and time again. And I only hope others will learn from my experience. I may never move on physically or emotionally - I’ve lost YEARS of my life at the hands of a surgeon I foolishly trusted. Every single aspect of my life has been detrimentally impacted and I’d give anything to go back in time.Below are photos of my nose - the first which is literally an hour after I left the doctor’s office immediately following the filler injection. The subsequent photos are of my nose in the days, weeks and months following the incident. I was patient, I waited YEARS to see if my skin condition would resolve as the doctor said it would and it never did. Please don’t let this happen to you. If my purpose in this lifetime is to warn and educate, then so be it.

Nose Fillers: Are the Risks Worth It? The Patient's TRUE Story

Nose Fillers: Are the Risks Worth It? The Patient's TRUE Story author: The Patient's TRUE Story. 

Nose Fillers: Are the Risks Worth It? The Patient's TRUE Story

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