Nonsurgical Rhinoplasty: 2 Typical Cases

David Mabrie, MD
Article by
Bay Area Facial Plastic Surgeon

Lately, many more patients considering nose reshaping are coming to our practice asking about "nonsurgical" rhinoplasty. I'll tell you what I tell them, and give a few examples of cases where the nonsurgical approach can be appropriate and effective.

What Is It?
Many doctors used to be skeptical of the idea of nonsurgical rhinoplasty, since there's obviously no way that injectable fillers could reduce the bony buildup that makes a nose looked large or hooked. But recently, more surgeons are using injectables for certain types of nasal enhancements.
 

Example 1: "Debra"http://www.yourfaceinourhands.com/photo-gallery/details.cfm?ID=226]
 

The Patient: This patient of middle-eastern descent (we'll call her Debra) had received multiple rhinoplasty surgeries from another surgeon before she came to me, and she's a great example of what fillers can do to correct "concave" areas.
The Procedure: In Debra's before photo, you can see how her previous surgery had left an indentation where her nasal bridge should be. Just by adding a little volume to her nasal bridge and her upper nose tip, I was able to correct that "scooped-out" shape and give her a straighter and less droopy nose. Her "after" photo is immediately after her injections, so her nose is a bit swollen, but that goes down within a few hours to a day.
Why It Worked: The changes are small and I was adding volume, not subtracting. If her nose had been more sharply down-turned at the tip, I'd have recommended minor surgery to adjust those soft tissues.
 

Example 2: "Janet" http://www.yourfaceinourhands.com/photo-gallery/details.cfm?ID=220
 

The Patient: This Caucasian patient's problem is the opposite of Debra's – instead of too little tissue at the bridge of her nose, she has too much. This makes her nose look large for her face.
The Procedure: The traditional logic would say I would need to correct that problem by performing a full rhinoplasty to reduce that bony hump. Instead, I just added volume to the upper portion of Janet's nose, between the eyes, smoothing out the whole line of her nasal bridge.
Why It Worked: Janet's nose really wasn't that large, and it didn't project too far in the first place. Her "before" photo looks a little that way since it's at an angle, but in reality her nose is a perfectly normal size – I just smoothed out the hump that was giving it the illusion of being "too big."