“Any sufficiently advanced technology is indistinguishable from magic.” British sci-fi author Arthur C. Clarke shared this idea back in 1973. The man was also a renowned futurist, we hear, but even he probably couldn’t have predicted how perfectly his words would one day capture modern beauty. While his quote could apply to everything from lipo to lasers, upon hearing it, our minds jump straight to nonsurgical rhinoplasty—a procedure that uses dermal fillers (and occasionally neuromodulators such as Botox) to temporarily reshape and refine the nose, and requires virtually no downtime. Commonly described as an optical illusion of sorts, the injectable treatment can make a dorsal hump vanish before your very eyes and change the appearance of the nose, making a prominent one look somehow smaller. For that reason, it’s colloquially referred to as a liquid nose job, and it’s an appealing option for many who don’t want to undergo plastic surgery.
The real trick, of course, is achieving these special effects safely, as the nose is among the most dangerous parts of the face to use injectable filler. “When I see inexperienced injectors from medspas putting filler in the nose, it makes me terrified,” says Dr. Kay Durairaj, a board-certified facial plastic surgeon in Pasadena, California. “I think there is an extreme risk for potential vascular occlusion, skin necrosis, and blindness—especially in the tip, where you can easily lose circulation to the nose.”
If you’re considering this procedure, our experts recommend choosing a rhinoplasty surgeon who is intimately familiar with the complex anatomy of the nose and can detect and reverse complications. For safety’s sake, they should use only an easily dissolvable hyaluronic acid filler, such as Restylane or Juvéderm, in the nose—and stock HA-melting hyaluronidase, to swiftly restore blood flow, should trouble arise.
Assuming a provider checks all those boxes, spend some time perusing their before-and-afters, bearing in mind these pro tips for spotting trustworthy images and covetable outcomes.
1. Honest and reliable images
If Instagram has taught us anything, it’s that seeing isn’t always believing. So how can you tell that an injector’s liquid rhinoplasty B&As are legit? For starters, they should be standardized medical photos, in which the background, lighting, and subject perspective are nearly identical in both shots. “You really want to see consistent size and depth of the patient’s face,” says Dr. Michael T. Somenek, a board-certified facial plastic surgeon in Washington, DC. If the before is taken close-up and the after is obviously pulled back, the nose will automatically look smaller, regardless of how it was treated. (Remember, adding hyaluronic acid filler to a nose truly can only increase its size, though by finessing proportions, injectors can sometimes make it appear more delicate.)
“The angle of the head is really important too, especially when looking at the profile,” Dr. Somenek adds. “If the chin is tilted up in the after, this can create a false sense of nasal tip elevation.”
It also helps to see injection rhino outcomes from multiple angles, i.e. in a photo gallery versus in just one or two photos—even better if those views are captured on video. While we’d encourage you to be skeptical of everything you see on social media, it’s generally harder to fake or doctor a video than it is still photos. As a bonus, after videos (or testimonial videos) allow you to gauge a patient’s immediate reaction to their new nose. “If they’re happy right off the bat, that’s usually a very good sign,” notes Dr. Durairaj.
A quick caveat about before pics: While finding a “before” that resembles the appearance of your nose—with a familiar hump or comparable amount of droop—may give you an idea of what outcomes are, perhaps, achievable for you, Dr. Somenek stresses that there’s often more to a nose than meets the eye. “Certain things are a bit more difficult to assess in photos, like the thickness of the patient’s skin, which can play a role in how much augmentation and definition we can create in the nose,” he explains. “If you see someone with a dorsal hump similar to yours but you’re of Middle Eastern ethnicity and they’re a Caucasian Irish person, your skin thicknesses are markedly different—so you may respond very differently to filler placed in the nose.” In other words, you can’t select/copy/paste a new nose, so be sure to keep your expectations in check. And, remember that not everyone is a good candidate for a liquid rhinoplasty procedure.
2. A natural forehead-to-nose transition
Doctors call the area where the nose meets the forehead our nasofrontal angle—and say this landmark can be quite revealing following a nonsurgical rhinoplasty. “I would most certainly look at the junction of the forehead and the radix [uppermost portion of the nose],” says Dr. Durairaj. When attempting to obscure a bump on the nasal bridge, injectors typically fill above and below it, in order to create a smooth contour. But adding too much gel to the radix “can very easily make someone look thick, bloated, and not pretty,” she adds. It’s a problem she’s commonly called upon to fix. “Dissolving liquid rhinos [done elsewhere] that look awkwardly enlarged at the radix—this is actually trending in my office right now,” she says.
Dr. Somenek agrees that overfilling the root of the nose can distort the nasofrontal angle, making it look as if the nose is coming off the forehead, he explains. “Balancing out the nasofrontal angle while also camouflaging the dorsal hump—that’s a good result to me.”
3. A subtly lifted tip
Even if the bump on your nose is your main motivation for getting a liquid rhinoplasty, a good injector will likely want to tweak your tip as well. In fact, Dr. Durairaj strongly advises against “spot treating” the bridge alone, as doing so prevents a “beautiful harmonization of the entire nose.” In her opinion, “treating only one subunit of the nose shows a limited ability of that injector.” And nobody wants that.
Using filler to lift or “rotate” the tip of the nose, as surgeons say, (even if it’s not particularly droopy) is an advanced skill, not only because the tip is a precarious place to inject but also due to the increased degree of difficulty involved with flipping a tip. Injectors must place the gel in a very precise location atop the cartilages in the area, to “create a natural curvature of the tip rather than accentuating its size” to bulbous effect, says Dr. Somenek.
4. Symmetrical nostrils
“When I see, on the frontal and profile views, that the margins of the nostrils have been corrected, that signals a great result,” Dr. Somenek says. Nostril asymmetries and irregularities—whether they’re congenital or an unfortunate consequence of surgical rhinoplasty—can be tricky to fix. Dropping the rim of a nostril down a mere millimeter or two requires next-level know-how and skill, doctors say—but when done well, this subtle change can be incredibly gratifying for patients.
Which is why “liquid rhinoplasty is starting to become more popular with revision patients,” Dr. Somenek says. “They’re seeing what types of results they can get with a non-surgical treatment—and avoiding an extra surgical procedure is, of course, very attractive.” However, he warns, patients who have had previous rhinoplasty surgery, especially more than one, are more prone to complications from filler, since their vasculature has been irreparably altered.
“There’s a very low percentage of patients that I’ll refuse to treat [with injection rhinoplasty],” Dr. Durairaj tells us. “But people who’ve had multiple revision surgeries and have a poor appearance to the skin of the nose—it’s shiny, thin, and obviously doesn’t have great blood flow—they’re very high risk, and I don’t like to go there.”
5. A balanced profile
When analyzing nonsurgical rhinoplasty results, especially from the side view, pay close attention to overall facial balance, suggests Dr. Durairaj. Look to see that all aspects of the nose were thoughtfully addressed—making it “look more aqualine and slim and contoured,” she says—while also ascertaining if the patient’s overall profile was appropriately tweaked during treatment. The relationship between the nose and the chin is especially critical, she notes. In order to present your new nose in the best possible light, your injector should make sure your chin has enough projection to support the revised proportions of your nose. As such, pairing a minor type of chin augmentation or enhancement with your liquid rhinoplasty may also be something to consider.
