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Get A New Nose in an Afternoon

July 30, 2012

Maybe it’s that little bump that no one notices but you. Or your nose is just not as straight as you would like, possibly with a little droop to the tip. You’re looking for a little nasal redesign— in short, you want a nose job but without the surgery. 

What is a Non-Surgical Nose Job?

Developed in 2004 by Yale trained cosmetic surgeon Dr. Alexander Rivkin, a non-surgical nose job is a non-invasive alternative to traditional surgical rhinoplasty. Also called injection rhinoplasty, it resolves the appearance of bumps, drooping tips and crooked noses, safely and quickly, without the risks and long, painful recovery normally associated with rhinoplasty surgery, according to Dr. Rivkin. [1] 

A non-surgical nose job can:

  • lift and straighten the tip of the nose, 
  • camouflage a bump 
  • correct a deviated nasal bridge or 
  • make a wide bridge or round tip appear more narrow and defined

How is it Done?

First, the area to be treated will be numbed, to eliminate any discomfort from the injections (about the same as any wrinkle injections such as with Radiesse). If the tip of the nose will be injected, Dr. Rivkin also recommends a dental numbing shot under the lip to the tip of the nose.

Then filler is injected in small amounts and in precise locations, giving the physician total control over the shape and contours created by the procedure. Because you are fully awake and aware, you will be able to provide feedback. Unlike surgical rhinoplasty, there is minimal recovery time, and any redness, swelling or bruising that occurs can almost always be easily camouflaged with make-up. 

The results are immediate, noted Dr. Rivkin, and can last from eight months to two years, depending on the type of filler that is used. Then, as your face changes over time, adjustments can be made to ensure a natural look.

What Type of Fillers are Used?


There are three types of injectable dermal fillers (sometimes called liquid face lift products) that can be used during a non-surgical nose job: Radiesse, Restylane and Artefill, the newest to receive FDA approval. 

Radiesse (calcium hydroxylapatite) can fill depressions, smooth out sharp angles or change the angle of the tip of the nose to restore symmetry and create the appearance of a smaller nose, according to Dr. Rivkin. The results will last about one year, after which time the filling is broken down by your body and gradually excreted, leaving the nose looking the same as it did before the injection.

Restylane is made of biodegradable, non-animal stabilized hyaluronic acid, a natural substance that provides volume and fullness to the skin. It does not require any allergy or skin test prior to injection. Restylane effects last about eight months, then are broken down by the body to dissolve evenly and symmetrically.

Artefill (Polymethylmethacrylate) — The first permanent injectable filler approved for the US market, ArteFill is composed of methyl methacrylate in a bovine collagen carrier together with the local anesthetic lidocaine. It does require a collagen skin test prior to use. Dr. Rivkin uses Artefill as a permanent version of his non-surgical treatments, reporting results similar to the effects of surgical rhinoplasty. [2]

How Does a Non-Surgical Nose Job Compare to Rhinoplasty?

While both conventional rhinoplasty (also called nose reshaping) and a non-surgical nose job can improve the shape and appearance of the nose, there are significant differences between the two techniques. 

Rhinoplasty (as explained on the American Society for Aesthetic Plastic Surgery website), is a surgical procedure that for the most part results in a permanent change to your nose. It may be performed in a hospital, free-standing ambulatory facility or office-based surgical suite, and requires medications such as local anesthesia and intravenous sedation or even general anesthesia.

The surgery involves removing small wedges of skin (rhinoplasty incisions), from inside the nose, in the natural crease where the nostril joins the cheek or across the vertical strip of tissue that separates the nostrils. This gives the surgeon access to the framework of your nose, to build up the cartilage or alter the position of the bones. If you have certain breathing problems caused by issues with internal nasal structures, your plastic surgeon might be able to modify them while reshaping your nose. Finally, the skin and soft tissue are redraped over the new framework.

Most patients are able to return home after several hours in the recovery area, although some may require an overnight stay. You may need to wear a splint on your nose until the tissues heal (up to a week), have a bandage beneath the tip of your nose, or packing or soft internal splints inside your nostrils.

You may have bruising around the eyes and cheeks for several days, with swelling lasting several weeks. During the first few days, you should also restrict your activities and sleep with your head elevated. Generally speaking, you should be able to return to work within a week or ten days and resume normal activities within three weeks. If packing was used, it will either dissolve on its own or be removed three to seven days post-surgery, along with any stitches.

Like any surgery, there are risks and potential complications, but these can be minimized by following your surgeon’s advice before and after surgery.

While you’ll be able to see a difference from your rhinoplasty within weeks, it can take up to a year for the final permanent results to be apparent. Occasionally some irregularities and asymmetries remain after the initial surgery, which can usually be fixed with injectable fillers according to Steven Dayan, MD, clinical assistant professor in the Department of Otolaryngology, University of Illinois Medical Center in Chicago.

A non-surgical nose job does not involve any incisions or need for anesthesia except for localized numbing, and so it does not carry the same risk as surgery or length of time as a traditional rhinoplasty recovery. Because it is more precise than surgical rhinoplasty, it permits more detailed adjustments to the nasal contour, according to Dr. Rivkin. Recovery is immediate and for the most part, you can resume normal activities.

Also, a non-surgical rhinoplasty is significantly less expensive than a traditional rhinoplasty. For example, Dr. Rivkin’s fee for a “15-minute nose job” at Westside Aesthetics, his southern California practice is $1,000 for the first treatment series (using Radiesse) and $900 for future Radiesse treatment series compared to an $8,000 to $15,000 average cost for a surgical nose job.

Keep in mind that, while a non-surgical nose job can correct any irregularities and create a straighter profile, it won’t change the overall size of your nose. And since the procedure is not permanent (unless Artefill is used), you’ll need to repeat the injections to maintain the desired appearance.

How to Know if it’s Right for You

To ensure the safety and success of the procedure, plastic surgeon Renato Saltz, MD recommends choosing a board-certified physician with relevant training and experience, since the technique requires a high level of skill combined with a thorough understanding of nasal structures and soft tissues. 

During your initial consultation, you and your physician should discuss:
  • what your needs and desired end results are, 
  • what filler would be best for your body and skin type and
  • how the procedure will be performed

You should also view before-and-after photos of other patients to have an idea of what to expect from the non-surgical nose job.

[1] http://www.westsidemedicalspa.com



 
 


 
 

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