Non Surgical Rhinoplasty Treatment

What is non-surgical Rhinoplasty?

Non-surgical Rhinoplasty is a recent development in the field of cosmetic surgery which does
not use any incisions on the patients nose. It is a procedure which allows reshaping the nose
without any invasive surgery.

This procedure is recommended for those people who are seeking a minor adjustment to the
size or shape of their nose. The procedure is completely safe and is approved by the
International Medical Association and U.S Food and Drug Administration (FDA).

Nose job without surgery can be successfully accomplished by using injectable fillers to
straighten the nose profile. The surgeon can fill in the depressions or smoothen out the hump
on the nose by filling in the adjoining areas.

The most commonly used dermal fillers for nose are Hyaluronic acid and calcium based
microsphere filler called Radiesse.

This procedure is used to correct almost all minor defects in the nose except the ones which
require a thorough cartilage harvesting and grafting. Droopy tip, bulbous nostrils, visible humps
on the bridge, uneven nostrils, weak nasal structure and any odd shape of the nose can be
corrected by non-surgical Rhinoplasty.

This non-surgical approach can neither cure breathing problems not reduce the size of the
nose. Since there is no incision and reduction surgery the nasal bone and supporting cartilages
remain unaltered. But, it can give the patient an aesthetically attractive nose by filling in the
areas which are causing imbalance and asymmetry.

The world has seen advancements in the field of facial plastic surgery where injectable fillers
are being used more and more. Patients are also becoming open to the new possibilities of non-
surgical treatments and enhancements.

History of Nose Job without Surgery

The early experiments began in the 19th century when two dynamic surgeons, James Corning
and Robert Gersuny, started using liquid paraffin wax to create the results which were obtained
by a regular Rhinoplasty surgery. These procedures were efficient, result-oriented, fast and had
negligible recovery time.

The non-surgical injectable fillers were for first used to elevate the collapsed dorsum which
leads to the saddle nose deformity. The fillers were also experimented on other deformities
with satisfactory results. But, despite the success of non-surgical fillers, liquid paraffin wax
started producing extreme reactions in patients and showed signs of creating biological
problems.
In the 60s, silicone gel was implemented in the Rhinoplasty surgery. The surgeons began
experimenting with a permanent nose job with these implants. But, like liquid paraffin, this too
started causing problems to the patients. Many people reported with ulcers and granulomas
(rejection of foreign particles by the body) after their surgery.

After extensive research Dr. Orentreich came up with an alternative technique called
microdroplet technique where small proportions of injectable silicone was used on the
patients over many sessions. But the contents of silicone gel were always objectionable as it
caused health problems to many patients over the years.

In 2002, an American surgeon called Dr. Alexander Rivkin started experimenting with injectable
fillers like Restylane and Radiesse. These were the only agents approved by the FDA for
Rhinoplasty during those years. Based on the success gained by this procedure, Dr Rivkin, in
2003, made the method public as non surgical nose job through American media. He also
used a synonym called injection Rhinoplasty.

In 2005, Dr. Andrew Le from Australia reported successful injection nose job by using
Polyacrylamide gel (PAAG), a hydrophilic colloid injected in the tissues to correct nasal defect.
This is also known by the name Aquamid in the market.

Who can opt for non-surgical nose job?

The surgeon usually recommends whether the patient has to go for a normal surgery or can get
the results with non-surgical procedures. However, the final decision is left with the patient and
he/she can decide after consulting their family members and other experts in the field of plastic
surgery.

Men and women of all age categories can safely use injectable fillers after having a skin test if
required. Children below 14 years are advised not to go for such surgeries as their nose is still
forming and taking shape. When they grow into an adult they can decide if they want to change
their appearance.

Sometimes the financial constraints can also lead to patient opting for a non-surgical nose job
instead of a full-fledged permanent surgery. The injectable fillers are temporary and have to be
replaced after about a year. But, the inexpensive fillers can be changed without much dent on
ones bank balance.

In some rare cases the surgeon finds that any kind of surgery can lead to further deterioration
of the facial muscles and cartilages. They may have been damaged beyond repair and the body
is too old to create new tissues. It might have lost the ability to create healthy muscle mass and
skin due to some disease. In such cases, the best option is non-surgical nose job. The patient
has to follow-up with the surgeon for future fillings as and when required.

People who are not happy with their primary Rhinoplasty can also be asked to go for non-
surgical fillings instead of a revision Rhinoplasty. Usually this will correct any minor deviations
which were left off during the first nose job. The patient is also relieved that he does not have
to go through the pain, discomfort and recovery phase like a normal nose surgery.

People from all ethnic background can safely consider non-surgical nose job and get the looks
they desire. The surgeon takes into account the ethnicity and does the filling to balance the
aesthetics of the face and the patients ethnic identity.

What can non-surgical Rhinoplasty correct?

Non-surgical nose job can create a near perfect nasal profile just like the surgical nose job. But
one limitation to this is that it cannot reduce the size of the nose or lessen the overall volume of
the nose. Since the entire procedure is a filler process, you can only expect to have smooth
contour of the nose.

Some of the things corrected by non-surgical nose job are

Depressed nasal dorsum leading to a flat nose. Injectable fillers increase the size of the
nose and make it look proper to the contour of the face.
Deviated projection of the nasal tip leading to lop-sided nostrils.
Retracted or weak columella leading either to a droopy nasal tip or upturned nose.
Deep creases along the nasal sidewalls
Humps or depressions on the nasal bridge
Enhancing interior nasal structure
Any minor injury to the nose

Surgical vs. Non-Surgical Nose Job

Surgical Nose Job Non-Surgical Nose Job

Meaning Incisions, cartilage
addition/reduction/grafting
procedures are carried out on the
nose with surgical instruments
Time Required Usually takes about an hour or
more with full-fledged surgical
unit, procedures and support
staff depending on the
complexity of the case
Decision Making Decision has to be made taking
into consideration time, family
support, availability, urgency of
the matter, medical history,
physical and mental fitness,
funding, surgeons expertise,
No incisions are made, only fillers
are used through syringes to
achieve the results
Usually is done within 15 minutes
with just the basic formalities
Decision can be made quickly as the
results are not permanent and the
patient can get on with their day to
day activities within a day
 location of surgery, post-
operative care, recovery time etc
Consultation Requires multiple consultations
with many plastic surgeons
(domestic and foreign)
Hospital Stay The patient is required to stay for
one night before the surgery and
may be one additional day after
surgery if needed
Cost Ranging from $4000 to $8000
requiring fully functional surgical
unit.
Bruising Swelling and bruising is visible
around nose, eyes and cheeks
Pain and discomfort Pain is felt usually in and around
nose area after the effects of
anesthesia subside and
discomfort remains for at least a
week after surgery
Recovery Takes about a year for complete
recovery and permanent nasal
profile setting in
Risks Involved Surgical risks regarding
anesthesia, medication, surgical
procedures, hematoma, internal
bleeding, post-surgery infection,
failed Rhinoplasty etc
Results Lasts permanently with gradual
decline due to wear and tear and
ageing
Reversing Ability Irreversible, but can be made
good through a revision
Rhinoplasty
Insurance Coverage Full or partial coverage if surgery
is done for functional reasons
(breathing problems) but not for
cosmetic reasons
Recent 3d Imaging used to simulate
Advancements post-surgery results showing
patients an image of their future
self along with improved surgical
units and post-operative care
Can be done with just one
consultation and fixing of
appointment
The case is treated as out-patient,
the procedures are carried out
quickly and discharge given
immediately
Less expensive and can be done at
the doctors clinic. Usually costs in
the range of $700 to $850 for one
syringe
Negligible swelling on the injectable
area which quickly wanes off
No pain as the injectable fillers
come with numbing agents mixed
and there is no discomfort as well
Quick recovery with instant results
Resistance or extreme reaction to
the agents used in the fillers
Requires refilling after every 9
months or a year
Reversible, where the surgeon can
control the filler and also melt any
excess with Hyaluronidase acid
No insurance coverage as the
procedure is purely done for
cosmetic reasons
Extensive research and
improvements in synthesizing
injectable fillers to harmoniously
become part of the body and not
create extreme reactions
Procedure for Non-Surgical Nose Job

The procedure involved is simple when compared to the surgical Rhinoplasty. The surgeon
usually gets the job done in 15 to 20 minutes on any day and the patient is given discharge
immediately. He can also resume his day to day activities the next day.

Some surgeons also give a saline injection to the patient to make them see, feel and experience
what it is like to go through the injectable fillers. The effects last for about 10 minutes where
the patient can decide whether this nose job is for them. After this, the actual treatment
begins.

The step-by-step procedure

Step 1: Pre-operative Checkups - The surgeon may make some general checkups of blood
pressure and other vital signs before starting to make sure that the procedures are completed
smoothly.

Step 2: Administering Anesthesia Usually for non-surgical Rhinoplasty general anesthesia is

not given. Some physicians use sedatives while others use Lidocaine injection to numb the area.

Step 3: Injecting Fillers A sterile syringe is used which comes pre-packed with filler agent and
a hypodermic needle. The physician injects the material deep under to nasal skin in the
subcutaneous tissues and creates the desired changes.

Step 4: Recovery Slight swelling, discomfort and stuffiness can be felt in the nasal area after
the filling. The patient can resume normal daily activities after an hour or so.

Step 5: Follow-up Since the fillings are temporary, lasting for at most 1 to 1 and a half year,
the patient has to go through future filling sessions until required.

Fillers Used in Non-Surgical Rhinoplasty

The earlier fillers used in non-surgical nose jobs caused adverse effects to the health of the
patients. As such, the FDA stepped in and created many safety measures and control checks
before administering these fillers. The surgeons have to take approval from the FDA before
using any new filler agent on their patients.

Some of the modern injectable fillers are as follows

Hyaluronic acid This is a naturally occurring substance and is found throughout the body of
most living organisms. It is the reason behind skin elasticity, volume and appearance of the
youthful skin. This is the only filler which is reversible. The surgeon can reduce the dosage by
melting away the excess dosage by injecting another enzyme called Hyaluronidase.
 Juvederm This is injectable facial filler used for cosmetic, dermatological and plastic
surgery to soften deep folds and reduce wrinkles in the face. Its main usage is in
removing smile lines and creases of facial skin. Various clinical studies were conducted
over the years to check the efficacy of this agent. They proved that Juvederm is safe and
gives better results than its competitor Zyplast, a filler made from collagen. This agent is
FDA approved.

Restylane This is a non-animal sourced hyaluronic acid (HA). This was the first acid
filler in United States approved by FDA for cosmetic injection into deeper dermal
tissues. This filler has been known to cause granulomatous (foreign body reaction). The
filler should not be used near areas where there has been a skin disease or
inflammation before. The filler has also been not tested on pregnant women.

Voluma This is a product which is used for similar reasons like other hyaluronic acids.
The side effects are similar to Restylane and should be used after skin testing and
eliminating any possibilities of infection or adverse reaction.

Perlane This is soft-tissue filler in the market approved to treat moderate creases
around the mouth. The surgeons, however, are authorized to use this agent on other
parts of the face to enhance the characteristics and rejuvenate the skin and volume.
This is slightly thicker when compared to Restylane and may be a better choice for filling
deeper lines.

Calcium Hydroxyapatite This is a calcium phosphate similar to the human hard tissues in
morphology and composition. It is considered more stable when compared to other calcium
phosphates. This is also more stable during physiological conditions such as temperature, pH
and body fluids interactions.

Radiesse This is an implant composed of synthetically produced smooth calcium

hydroxyapatite (CaHA) microspheres suspended in a sodium carboxymethylcellulose gel
carrier. This is FDA approved dermal filler requiring minimal invasive procedure
producing immediate results. The filling lasts up to 14 months.

Liquid Silicone This is a gel which is used through microdroplet technique over various
sessions in the clinic. It is also used for breast implants, testicle implants, pectoral implants etc.
Since the synthetic compound is highly biocompatible it is advised by the surgeons for
injectable filling. Only the medical grade silicone is approved by the FDA and its quality has to
pass stringent tests before administering to the patient.

Polymethylmethacrylate(PMMA) This is permanent filler made from microscopic plastic

beads. A skin test is required before administering. Tiny PMMA microsphere are suspended in
biological fluids and injected to deeper parts of the nasal tissues to restructure the nose.
PMMA is highly compatible with human tissues and as such is widely used for eyeglass lenses. It
is also used as bone cement to affix implants and restructure nasal bone. Although this material
is compatible it is considered a carcinogen and has been linked to cardiovascular events.

Artefill This is a permanent injectable wrinkle filler to smoothen out the smile lines. It
was approved by the FDA in 2006. It is a gel suspension of 20% PMMA, 30 to 42 micron
microspheres, 3.5% collagen derived from cows and 0.3% Lidocaine. Since this material
is not absorbed by the body it provides a permanent structure into which the nasal
tissues can grow. These can be removed only by cutting them.

Artefill is not recommended for people who have bovine collagen/lidocaine allergy or
sensitivity to foreign objects. There is also a risk of eventual overgrowth of tissues if the
injectable is not controlled.

Polyacrylamide Gel (PAGE) This is permanent filler used to achieve results like the usual
surgical Rhinoplasty. This is used for patients with ethnic backgrounds. This filling is not
approved by FDA.

Aquamid This is a non-absorbable permanent soft-tissue filler agent meant for

cosmetic surgery. It contains approximately 97% water and 3% cross-linked
polyacrylamide. The agent is released into the deeper surface of the nasal skin to
correct wrinkles, folds and even out any asymmetrical shape.

Various clinical trials over the years have been conducted to support the safety of this
agent. But, FDA has not yet approved this agent in USA. It is available in other countries
Europe, Asia, Latin America and Middle East.

Financing the Non-Surgical Rhinoplasty

Although the cost of injectable filler is just 1/10th of an actual Rhinoplasty surgery, you have to
take into consideration the temporary nature of this procedure. You are required to visit the
doctors clinic every year and spend the amount for the injection.

Sometimes, a single injection may not be enough for the entire procedure to be successful. The
physician has to make use of another syringe which will add up the total cost. Therefore, if this
idea makes you nervous, it is better to give a second thought before opting for a nose job
without surgery.

The permanent fillers discussed above may not suit your body type and your surgeon may go
for the temporary ones. Even with the permanent fillers there are possibilities of them creating
an unwanted reaction in the body later on and you may have to visit the clinic again for
replacing them with new ones.

The insurance company does not cover such cosmetic procedures unless a functional problem
is proved through a medical test. Moreover, you should be careful and read through the clauses
given in fine print of your health policy. You have check whether such cosmetic surgeries can
make your future claims null and void.

The banks may give you a personal loan depending on the prevailing rate or interest. But, if you
have to go for a bank loan for a non-surgical Rhinoplasty, it is better to wait until your financial
condition improves. It is always better to make the payment from your savings instead of
creating a new debt.

Recent Advancement in the field of non-surgical nose job

With the emergence of Vectra 3d imaging technology the surgeon is able to take pictures of
patients face and create a 3d image to show how the procedure will change the shape and size
of the nose.

The technology also guides the surgeon by taking into consideration various angular
calculations to provide the best results for surgery. It also takes into account the typical traits
exhibited by people from various ethnicities and helps the surgeon maintain them while he is
operating on the nose.

Final words on Nose Job without Surgery

Nose job without surgery is becoming more and more popular with the patients who are
unwilling to shell thousands of dollars for a surgery. The mainstream media is catching up with
the astounding results achieved by injectable fillers in enhancing the beauty of the face by
correcting the nasal structure.

The temporary results are a boon in disguise, as, if something goes wrong and the patient is
unhappy with the results he will know that the results will not last for long. Overall, this new
technique in providing an aesthetically attractive nose is proving to be successful.

Article By: kuwaitrhinoplasty.com