Non-Surgical Rhinoplasty; Clearing Several Misconceptions
Over the past year, I’ve seen more prospective patients interested in learning more about non-surgical rhinoplasty. However, many of those patients were not ideal candidates for the procedure. Of course, who would not want an immediate solution for characteristics of a nose that one is dissatisfied with? A solution that does not require incisions or the fracturing of bones sounds even more appealing. Sometimes a solution like that is too good to be true.
About Non-Surgical Rhinoplasty
Non-surgical rhinoplasty employs the use of injectable fillers as a means to alter the shape of the nose. The types of nasal deformities that lend themselves to such alterations are somewhat limited. The defect best served with injected fillers is one caused by previous surgery or trauma. In the case where there is a depression or an irregularity of the bridge or dorsum of the nose, injecting a filler can be a quick and simple solution.
Smooth an Irregular Dorsum
Non-surgical rhinoplasty is like filling an annoying pothole in a frequently traveled road. By injecting a hydroxyapatite type filler such as Radiesse® into a bony deformity, you can smooth out an irregular dorsum which can easily capture an observer’s eye.
Reduce a Dorsal Hump or Bump
Another area where an injection can correct a nagging trait is a minor dorsal hump or bump. By building up the dorsum above and below the hump, the hump seems to disappear. Similarly, building up a dorsum which been overly reduced by an aggressive surgeon is another great application of non-surgical rhinoplasty. This can quickly improve a profile that once produced anxiety. This technique can also be used when someone has a depressed nasal bone following a nasal fracture that has either been reduced inadequately or not addressed at all.
Address a Nasal Tip Deformity
Deformities of the nasal tip can also be addressed in a limited capacity. Under projected noses can undergo an augmentation with a hyaluronic acid such as Restylane®. Likewise, a tip rotated downward can get a visual lift by injecting the area just below the tip depending on the degree and location of such a droop. In some cases, an asymmetric tip can also be corrected. Of course, all of these issues need to be thoroughly examined and assessed before it can be determined that injectables will be useful.
Potential Complications of Non-Surgical Rhinoplasty
There are several complications that should be considered before proceeding with non-surgical rhinoplasty. Obviously, there can be over or under injection which could lead to inadequate correction or over correction. In the first case simply performing additional injections will suffice. In the second case, only hyaluronic acid can be “dissolved” with an enzyme called “hyaluronidase” which could be injected into the treated location.
A more serious complication is the occlusion of blood supply to the skin over the nose, which may occur if the injection is too superficial and is inadvertently introduced into an artery. This could lead to loss of skin and ulceration and ultimately disfiguring scars. Treatment for this occurrence is an emergency and requires dissolution of the material with hyaluronidase and the use of vasodilators to improve blood flow to the area. The important take-home message is that even though these techniques are non-surgical, they are not without risk.
The Bottom Line
Overall, the use of injectable fillers to provide augmentations to select areas of the nose to correct a variety of deformities has been very successful. It is important to know that these corrections are not permanent although there will always be some residual corrective effect. However, making these temporary changes is an excellent lead to a more permanent change with surgery when the time is right.
