Many patients come to my office with questions about a non surgical approach to nose reshaping (rhinoplasty). Nose reshaping is a complex operation. It requires both technical expertise and artistic skill to balance the nose in an aesthetically pleasing contour. Traditionally this has been done with cutting and using various tissues to graft or augment the nasal anatomy as needed. Recently, some new filler materials have become available that have shown some promise in achieving improvements to nasal appearance without cutting. The non surgical rhinoplasty usually involves injecting a filler material, usually a derivative of hyaluronic acid into the nose. Based on the placement of the material nasal shape may be improved. The benefits of this procedure are numerous. It is usually less costly than a traditional rhinoplasty. It can be frequently performed in an office setting without general anesthetic. The procedure is much quicker and may be less painful than traditional surgery. There is less downtime after the procedure, and patients frequently return to their normal activities right after the procedure. The material is not permanent, so if the result is not what the patient had hoped, it will eventually disappear. An injectable material to help dissolve the product is also available to immediately remove product if needed. There are limitations to the procedure. Not all patients are good candidates for this technique. If you have significant deformities or nasal obstruction, a traditional surgical approach may be the best option. If the material becomes infected, there is a risk of skin damage and loss over the nose which may be difficult if not impossible to correct. The procedure is new so no one has a ten year experience with the technique, some unexpected problems may arise in the future. Injecting the product into the nose may cause scarring in the nasal tissues making a subsequent surgical rhinoplasty more difficult. The non surgical nose job is a good procedure for some patients. It is best to discuss this with your nasal surgeon to find out if this is the right procedure for you.

5 things that a rhinoplasty can change Rhinoplasty is the reshaping of the nose. It is a complex procedure and results can be variable. Experience and knowledge play an important role in consistently good rhinoplasty results. What are the things that a rhinoplasty can reliably change on your nose? My nose is too big The perception that a nose is too big is often incorrect. It may just be that the proportions are not balanced. “Make my nose smaller” is a common presenting statement for a patient. A rhinoplasty can “make your nose smaller”. This usually means readjusting the proportions of the nose for better balance. I have a large hump on my nose Nasal aesthetic surgery can remove bumps on the top of the nose. Dorsal irregularities are common and can be reliably improved with rhinoplasty. The surgeon must be very careful in patients with thin skin to smooth out all underlying irregularities to remove any bumps My tip is too wide A wide or boxy tip can be refined with a rhinoplasty. There are many tip refinement techniques that a modern rhinoplasty surgeon can employ to narrow the tip. Over-narrowing must be avoided; this may create a collapse of the tip supports and lead to cosmetic deformity and nasal obstruction. I have a twisted nose A curve to the entire nose is not uncommon. This can result from previous surgery, previous trauma or a natural phenomenon. This is something that is very hard to correct. The surgeon must always warn the patient that the curve may be improved but not eliminated. The methods to correct this may involve placing tissue on top of the curve or breaking the bones of the nose to reshape them. My nose is blocked Cosmetic nasal surgery always has a functional component. Unless the surgeon is skilled at surgery to improve the nasal airway this may not be appreciated. A person may have no nasal problems, but a cosmetic nasal procedure may alter the nose in such a way that a nasal obstruction results. If the surgeon is not aware of the nasal anatomy, they will not take the necessary steps to avoid this common post-op problem. All nasal surgery should preserve nasal function, maintaining breathing.

This term refers to surgery of the nasal tip. This region is comprised of the lower nasal cartilages, skin and the septal support. The precise surgery performed will vary with the goals and the specific patient anatomy. Surgery of the nasal tip can be performed under local anesthetic and intravenous sedation. However, the tip has a profound effect on the appearance of the nose and the final result of a rhinoplasty. My personal preference is to perform tip surgery under a general anesthetic in most cases to ensure placement of tissues in the precise position for optimal results. Frequently surgery of the nasal tip is performed as part of a full reshaping of the nose: a septorhinoplasty. This may also include breaking of the bones around the nose to complete the reshaping process. It is best to contact an experienced rhinoplasty surgeon to determine if surgery on the nasal tip is all that is required or if another procedure may be of benefit.

Rhinoplasty in patients of African, South Asian or East Asian origin Rhinoplasty or nose reshaping is widely regarded as one of the most complex cosmetic surgical procedures. The surgeon must have sound surgical skills, a detailed knowledge of anatomy, and a wide range of techniques to treat various deformities. In addition to all these skills, a sense of artistry is needed to combine everything into a balanced aesthetic nose. Balance. Harmony. Proportion. These are the fundamentals of good rhinoplasty surgery. The nose of a patient of African, South Asian, or East Asian origin poses unique challenges to gain a superior result. Many of the analytic tools used to assess a Caucasian nose are not always useful. Typically the alar width (base of the nose) is wider resulting in a different shape to the ala and a wider tip. The nasal dorsum may not be a high as a Caucasian nose. The skin is generally thicker, and different techniques may be necessary to effect changes in the shape of the nose. These are just a few of the differences that must be clearly understood by the surgeon to achieve a superior result. The surgeon must completely understand this type of rhinoplasty and how to use the inherent characteristics of that particular patient and shape of the nose to advantage. It is best to choose a surgeon with extensive experience with this type of rhinoplasty. If such a surgeon is not available in your community, it may be best to search for a surgeon with these skills. Asking the surgeon to show you some of his patient results is the easiest way to determine his experience with this type of complex surgery.