Restylane or Juvederm should be avoided in the nasal tip
Restylane or Juvederm should be avoided in the nasal tip due to the risk of tip necrosis. This is a horrible complication to get. I have seen this occur in a patient treated elsewhere and it is hard to correct. The product or any injectable filler injected into the tip of the nose can result in vascular compromise and block the blood supply to the nose in that area. Along the top of the nose or dorsum it is safer in that area to use due to a greater blood supply. A better option might be to do a limited rhinoplasty.
Non surgical rhinoplasty - Restylane
The most common fillers used to perform
non-surgical rhinoplasty are Radiesse (calcium hydroxyapatite microspheres),
Restylane and Perlane (hyaluronic acids). They are an attractive option
for a subset of patients, because it can produce pretty
significant changes without the surgery. The caveat is the risk
associated with it, and the temporary nature of the filler. It is safest
when used to build up the bridge of the nose (dorsal augmentation). This
will make the nose appear "higher and thinner". When used in the
tip and columella, the blood supply is a bit more tenuous and the risk of
complications higher. With judicious injection, it can be used to safely
refine the tip and make it appear "pointier and thinner".
Increasing the tip projection will give the illusion of having lightly
less wide nostrils. Some of my patients use it as a way to "try
out" a higher bridge before undergoing surgery. WIth repeated
injections the skin quality can be affected, so I would advise a couple things:
1) never inject something permanent 2) choose a surgeon with broad
experience with Asian rhinoplasty and non-surgical rhinoplasty 3) if
you're considering surgical rhinoplasty, avoid repeated injections.
Restylane Injection in the Nose?
If the bridge of your nose has sunken, it sounds as if you will require some form of dorsal augmentation instead of injecting the tip of the nose. If this is true, the Radiesse would be a better choice due to its better volumizing capacity. That being said, fillers in the nose are an imperfect and temporary solution for this problem. All fillers carry a small but real risk of skin necrosis if injected directly into local blood vessels.
There is a remote risk of interference with blood flow to the nasal tip, or the region between the eyebrows if fillers are injected in the bridge or tip, If this occurs, the skin may develop an ulceration followed by a permanent scar. Excellent technique may not prevent this, but using a thin, not thick filler, and being conservative wtihout overfilling are important aspects of minimizing the risk. I have performed, with excellent results, filling nasal tip depressions after Mohs micrographic surgery for skin cancer. However, treating a nose for cosmetic improvement is very different than improving a scar that exists after reconstructive surgery for a skin cancer removal. If a scar develops after treating an unscarred nose for cosmetic puroposes, then this complication will be more bothersome to the patient and physician!
The answer is yes, it can, but the notes that others have posted about tip necrosis are a minor issue. In my opinion, the risk of tip skin necrosis is so low that fillers to the tip are reasonable options. The majority of studies to date describe radiesse for non surgical rhinoplasty, but fillers like restylane and juvederm also apply. And because restylane and juvederm are reversible, may be more straight forward.
The issue that I feel is more important tries to define what realistic improvements are achieveable. The fillers can add some diffuse fullness to a tip, but not the definition that patients often desire. Or, attempts to create more of that pointy tip that some patients describe (ie more definition) require volumes of filler that are less predictable. And an article by Toriumi describes the difficulty in removing radiesse if a patient quickly follows with rhinoplasty.
So in the end, I do use it in the tip, feel it is safe, and effectively adds tip volume. Definition is harder to promise.
Dorsal (bridge) augmentation works much more reliably as well with all the fillers.
Restylane Volume Enhancement of the Nose
Restylane and other hyaluronic acid facial fillers can be effectively used in the nose provided that a knowledgeable plastic surgeon has assessed the vascularity and skin perfusion of the tip and dorsum of the nose. Further, it seems that you lack structural support of the nasal dorsum and Restylane cannot provide any structural support.
Nose tip and bridge are two areas to be cautious
The risk of vascular compromise (from filler compressing blood vessels) is higher in these two areas. The nose tip in particular can be problematic if you have had previous rhinoplasty. It is not a "no", but rather a "caution" and be sure the doctor is an expert. It is a "no" for smokers.
Restylane can be injected into the nose
Yes, Restylane, Perlane or Juvederm can be injected into the nasal tip (or any other part of the nose) to correct minor discrepancies in contour. It can also be used to improve the appearance of mild 'supra-tip' deformities where there is excessive fullness of the area above the nasal tip. The filler is injected into the subcutaneous tissue or deep dermis, and usually lasts up to year.
Definitely, though Radiesse would be my choice
I was asked this question in a filler workshop I was running in Vienna. Restylane as well as any of the HA fillers can be injected, though I prefer Radiesse over them since it's a sturdier material that can last longer. Indications for the filler should be present and not anyone can benefit from it.
Restylane can be injected into the nose for minor deformities. It can last for 6-12 months. A more permanent correction would obviously be through a rhinoplasty.