With the advent of fillers we can reshape the nose without surgery. Traditionally, rhinoplasty was done through surgery alone, where we changed the structure of the cartilage and bone to give the nose a new shape. Most patients come in with areas of their nose that they want adjusted, such as a bump on the bridge or they may want their nose narrowed or shortened, and surgery used to be the only option.
Now with filler, we can re-contour the nose to give it a more balanced appearance. We can hide a bump, lift a tip, or make a nose look straighter. What we cannot do with filler is make the nose smaller. The good part is that many patients who think they want a smaller nose really just need a more balanced nose, and filler can accomplish this.
How is nose filler used?
A good example is a patient who has a bump on the bridge of their nose. We can camouflage the bump and give them a straight profile by adding filler above and below the bump. In certain patients, if we augment the soft tissues with filler, it’s almost like we’ve used a cartilage graft. but didn’t. We can make a wide nose look more narrow by lifting the tip with filler, almost in the same way that a higher tent pole gives the appearance of a narrower tent.
The important thing is that the surgeon discusses with the patient that filler will not give them a smaller nose. In fact, the nose will be physically larger but may look smaller and more balanced. We can’t subtract with filler, we can only add. We also cannot maximize the airway with filler. That must be done with surgery, but we can sometimes camouflage an irregularity that came from a prior surgical rhinoplasty.
Using filler to augment the nose requires a surgeon who’s very discerning and the problem is that today many people are injecting filler and they don’t have the experience with noses. This can be a big problem because of the risk of vascular occlusion. This is where filler gets injected into a blood vessel and there are a lot of blood vessels in the nose. Though rare, this can cause skin necrosis and sometimes, blindness. These complications happen very infrequently, and if you go to someone who really understands the anatomy, the chances are a lot lower, but they’re not zero.
For the right patient with the right surgeon, a non-surgical rhinoplasty is a great choice. Patients love it because the change is immediate with no downtime. As a patient you have to weigh the risks. I find most of my patients that have non-surgical rhinoplasties are very happy with the outcome.
What is the best filler for non-surgical rhinoplasty?
There are more than one filler that is best for non-surgical rhinoplasty, such as Restylane Lyft, Juvederm Ultra, Juvederm Ultra Plus, and Juvederm Voluma. These are fillers that have enough G prime, which is tissue moving ability and they are made up of hyaluronic acid which is dissolvable. If a complication occurs, I am able to reverse it.
The nose is an important element to our beauty. It’s right in the center of our face. When people look at us they look at our eyes, nose, and mouth. The nose is at the center of this triangle and something that, when balanced, can bring all your features together. A non-surgical rhinoplasty is a really wonderful solution to any asymmetries.
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About Dr. Jonathan Sykes
Dr. Jonathan Sykes is a world-famous expert plastic surgeon who performs all cosmetic and functional plastic surgery procedures on the face and neck. He is a past president of The American Academy of Facial Plastic and Reconstructive Surgery, and served on their Board of Directors for over 10 years. He is also a Professor Emeritus in Facial Plastic Surgery from UC Davis Medical Center, and the former Director of Facial Plastic Surgery at that institution. He is known as the expert’s expert, and is often called to consult and advise other plastic surgeons in both Northern California and Beverly Hills. He has a special interest in eyelid and browlift surgery, facial rejuvenation surgery, including facelifts and rhinoplasty.