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The nose gives a person a lot of character. And contrary to common belief, it's not a one size fits all. So if you look at the nose, there are different options that you can offer a patient, from a non-surgical rhinoplasty to a surgical rhinoplasty. Obviously, it depends on the person, their desire, the way they perceive their own beauty as reflected by their nose, and, you know, obviously give them an artistic and natural look. When we talk about non-surgical rhinoplasty, you know, there are limitations. When you don't do surgery on a nose, you use injectables or fillers to either improve the shape of the nose, to make the tip a little bit more prominent, to hide a bump. If there's a little bit of asymmetry because somebody had a septoplasty and the nose is a little bit crooked, you can improve the shape, but within reason, that you cannot go as far as you can go with a surgical rhinoplasty, of course. When it comes to a surgical rhinoplasty, noses are divided into two types of noses. Noses that have never been operated on before or have not had trauma, which means primary rhinoplasty, so you are essentially operating on a virgin nose or a secondary rhinoplasty, a nose that has been operated on before, if you will. And a nose that has not been operated on before is an easier nose to deal with versus a nose that has been operated on before, because the anatomy has been altered, there has been scar tissue, and the blood supply is a little bit more difficult to deal with.

You can have non-surgical versus a surgical approach. The non-surgical approach can be simply a patient's choice. They come speak to me and say, "I'm too scared to have a nose job or I don't want to have surgery, what can you do to improve my nose?" And basically, it's the improvements that you can do can be subtle improvements. For example, if somebody has a bump on their nose, you can inject a little bit of a filler above and below that bump to camouflage it. Or if somebody's nose is bulbous, for example an African-American nose or Hispanic or an Asian nose, but they want a little bit more definition, you can inject some filler in the tip of the nose to make it look nicer and more prominent. If somebody had had surgery on their nose and they don't want to have more surgery, they want to have a little bit of an improvement in the shape and the symmetry of the nose, that's when a non-surgical rhinoplasty can be as well beneficial.

The advantages over a surgical rhinoplasty is it's obviously very quick. You know, ten minutes, we numb up the nose first and then the injection takes, you know, anywhere from five to ten minutes. It's less expensive. It could cost probably one-tenth or one-fifth of a rhinoplasty procedure. The results are not permanent, so if you're not happy with them, you don't have to repeat it. Typically, it can last a year to two years, so it's long enough that makes it worth doing, but not permanent so that if you don't like it, you don't have to, you know, live with it. And, it's much less painful, there's no healing time. You can go back to your activities within an hour or so. I tell people you can have some bruising for the next day or two but not necessarily. And it's very flexible. You can put a little bit of filler in the nose, a lot of filler, you can do different types of fillers, from the hyaluronic acids to the more longer term fillers. For example, you can put Perlane in the nose, which is hyaluronic acid or Radiesse in the nose, which is a more permanent filler. Now, we have Voluma available. Injecting it in the nose as all these fillers would be an off-label usage that you have to really talk to a plastic surgeon who is very familiar and very experienced in doing it, not somebody who is doing it on you that doesn't do it hundreds of times a year to give you the best results.

When it comes to surgical rhinoplasties, it's the opposite. It's somebody who wants a more drastic result. Somebody who wants a more difficult result to achieve then what you can than with a non-surgical rhinoplasty. Somebody who has difficulty breathing, you cannot fix the difficulty of breathing with a non-surgical rhinoplasty. You need to do some type of surgery for them. And somebody who has a bigger nose and wants to make it smaller, you cannot make a small nose smaller by injecting it with fillers. So those are some of the differences between a non-surgical and a surgical rhinoplasty.

Rhinoplasty Options: Surgical and Non-Surgical

Dr. George Bitar discusses in detail the difference between a surgical and non-surgical nose job and the specific concerns each approach is able to address.

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