Dermal fillers are primarily used to fill in depressions caused by facial aging or hereditary predisposition (e.g., flat cheeks). However, doctors are now starting to use them in non-surgical rhinoplasty although their use can be quite limiting.
Renowned Los Angeles plastic surgeon Dr. Tarick Smiley says fillers only suit patients with minor nasal deformity: a small hump or irregularity along their nasal profile. Those who require minimal bridge augmentation may also consider this non-surgical approach.
Patients with severe or more complex nasal deformity—e.g., drooping tip, significant nostril flare, large bridge, etc.—will need the standard rhinoplasty, a surgery in which the bony and cartilaginous framework of the nose is reshaped. It is important to consider the patient’s skin shrinkage to ensure that it can redrape well to the new contour, instead of appearing amorphous especially at the tip.
When performing non-surgical rhinoplasty, Dr. Smiley only uses FDA-approved fillers to conceal minor imperfections of the nose. Hyaluronic acid-based materials like Juvederm and Restylane are the ideal choice since they can be easily reversed should the patient is not happy with the results; an enzyme called hyaluronidase can be injected into the tissue to dissolve the particles.
Hyaluronic acid-based fillers generally last four to six months and so they require upkeep should the patients want to preserve their results.
For patients who want longer-lasting fillers, one possible alternative is to use Radiesse whose results can last between nine and 15 months. Its main ingredient is calcium compound, which is not easily broken down by the body.
Meanwhile, permanent fillers such as silicone injection should be avoided due to increased risk of lasting deformity, infection, and skin injury, Dr. Smiley says in a previous Snapchat post.
One of the selling points of fillers is the zero downtime, while rhinoplasty typically requires 7-10 days of social recovery due to the postop bruising and swelling.
Despite the impressive safety track record of FDA-approved fillers, they nonetheless demand meticulous injection to avoid skin changes (redness), lumpy appearance, and skin necrosis (death of tissue). Hence, a prudent patient ensures that only a licensed/qualified injector does her procedure.