Everyone is talking about adding fillers to define their cheekbones, fill in their wrinkles or increase their pout… but now women and men are using these miracle syringes to change the appearance of their nose.  The term liquid rhinoplasty is becoming more and more popular on social media and in the news.  Liquid rhinoplasty refers to a non-surgical rhinoplasty in which dermal fillers and/or Botox is injected into your nose to help balance nasal proportions.  According to RealSelf, liquid rhinoplasty is one of the most-visited minimally invasive topics on their website.

The Details

During a liquid rhinoplasty, your nose is iced to numb the skin.  Using very small needles, hyaluronic acid-based dermal fillers like juvaderm, voluma, or restylane are injected into the nose to smooth irregularities.  These fillers are easy to mold and shape once injected.  Botox can be added to eliminate “bunny lines.”  The procedure is designed to achieve an aesthetic result without using a scalpel or requiring downtime.

The Candidate

Although most patients are candidates for dermal fillers and Botox, a liquid rhinoplasty is best for patients who complain of irregularities along the bridge of their nose, a flat or depressed nasal bridge, a small to medium dorsal hump, or who wish to have their nose appear slightly straighter.  Patients who complain of a poorly defined tip, bulbous tip, drooping tip or who wish to have a smaller nose benefit from a surgical rhinoplasty.  Some patients present after they have had a traditional rhinoplasty because they are not satisfied with the result due to tiny lumps and bumps or slight asymmetries between the two halves of the nose.  For the right candidate, a liquid rhinoplasty can improve your profile by hiding a dorsal hump, make a crooked nose appear straighter, build up the bridge of your nose and improve the results from a previous rhinoplasty.

Syringe or Scalpel

There is little to no downtime with a liquid rhinoplasty.  Bruising is rare and most people go back to work immediately afterwards.  The results are instant and without significant swelling.  Liquid rhinoplasties are excellent for correcting minor depressions and hollows but will not make your nose smaller or define the tip of your nose.  It is a very safe procedure with a low complication rate.  If you do not like the results, the fillers can be dissolved within 24 hours.

Off Limits

It cannot make a very crooked nose perfectly straight as this non-surgical rhinoplasty is only camouflaging the features of your nose that make it appear crooked.  It cannot lift the tip of your nose.  By adding filler to the tip of your nose, you will be adding volume to an already droppy or sagging tip and thus exaggerating what you wish to hide.  It cannot fix a breathing problem.  Breathing problems are related to deviated septums or internal anatomic problems not contour irregularities.  Surgery is the only option to improve structural problems leading to breathing difficulties.

Pump It Up

Often patients question if adding volume will make their nose appear larger.  The dermal fillers are injected in micro-aliquots so that the nose does not appear larger but appears harmonious or balanced.  By making the nose appear more balanced, it often appears more refined.

Lasting Power

A liquid rhinoplasty lasts for one to two years depending on which dermal filler is used, area of the nose being treated and patient factors.  Each filler has a particular life expectancy.  Each patient metabolizes injectable fillers at a different rate.

Just Not Me

The fillers that I use are reversible.  By injecting an enzyme called hyaluronidase, I can dissolve the filler if you do not like the effect.

The Traditionalist

The fillers added do not interfere or prevent a future rhinoplasty.  Many patients consider a liquid rhinoplasty to be a practice run, helping them understand how their nose will change with surgery.

The Negatives

Although the results will last for one to two years depending on which filler you choose, they are not permanent.  It will not make your nose smaller or add definition to the tip of your nose.  Although for most patients a liquid rhinoplasty is less frightening than surgery, adding fillers do have risks.  Vascular compromise can lead to skin necrosis or the death of skin due to decreased blood flow to the area.  This can occur if the filler material enters blood vessels or if the filler material applies too much pressure to the overlying skin.  When I inject, I always draw back on the filler syringe to confirm that I am not in a blood vessel and I inject in a retrograde method which has been shown to be safer.  I also always keep hyaluronidase in the office to quickly dissolve the filler if there are any problems.  Studies have shown that the rate of vascular compromise after filler injection is 0.05% even in the hands of highly trained physician injectors.

Recovery

Do not push on, massage, or apply pressure to your nose for the first week.  After one week, there are no activity restrictions.  You can wear make-up immediately after the procedure.  You can shower or swim the same day.

First Step

If you have been thinking about having a liquid rhinoplasty, please call our office at 212.600.4109 to arrange for a consultation.  Our New York City practice accommodates out of town and international patients who need to travel in for surgery as well as those who are local to Manhattan.