Asian Nose-should I Go for the Non Surgical/surgical?

Question

I have this typical asian nose, the wide and flat nose. i'm thinking about rhinoplasty for few months. i actually prefer the non surgical rhinoplasty but some said that its not permanent. but some said that it would be permanent with silikon-100 filler. can the non surgical rhinoplasty give the permanent result or not? and for my asian nose, which one is better, surgical or non surgical?

Charles S. Lee, MD, FACS · Answer

Injectables for augmenting the bridge does not yield attractive results. The materials that are safe to use in the nose do not "stack" very well and have a propensity to slide down the sides, like trying to build a mountain using sand. This results in a wide and blobby appearance, whether along the bridge or in the tip. 

	The tip is especially difficult to get a refined appearance, because the weakness in the cartilage structure prevents significant augmentation. The injection can be place from the undersurface (nostril side), but even with this technique the results are limited.

Michael A. Persky, MD · Answer

Hi JFJ,

	Though there are a very few Silikon-1000 injecting physicians who have had great success with silicone in the nose, they are the exception.  The problem with permanent fillers is permanent (and very difficult to treat) complications.  You may try a hyaluronic acid filler such as Restylane or Juvederm first, but I would strongly recommend a rhinoplasty surgically for permanent results.  Good luck and be well.

	Dr. P

Amir M. Karam, MD · Answer

Generally, to narrow the nose and refine the tip, a rhinoplasty is required. Alternatively, to improve the profile and raise the bridge or tip projection, filler can be used. I personally, always favor a surgical approach, however, if the patient opts for the non-surgical approach, a filler like restylane is a safer alternative to silicone.

Jeffrey Epstein, MD, FACS · Answer

Here in the US, there are no injectable implants that are permanent that also are approved for use in the nose. That is not to say that repeated injections of fillers is not a bad option, however, as an experienced rhinoplasty surgeon, I prefer the natural long lasting results that can be achieved through rhinoplasty surgery.

Kimberly Lee, MD · Answer

It depends on what you are trying to achieve with your Asian Rhinoplasty. If you are just trying to build your bridge, then a filler may be an option. However, in my experience most patients opt for a more permanent solution. I prefer to use cartilage from your own body instead of foreign material for a more natural and balanced appearance that fits your face. Often Asians also have flaring, wide nostrils that cannot be addressed non-surgically. When choosing a facial plastic surgeon, please also keep in mind that while aesthetic results are a concern, you still want to be able to breathe out of your nose!

Taimur Shoaib, MD · Answer

I have had some very nice results with hyaluronic acid fillers when doing non surgical rhinoplasty, using products such as Restylane and Juverderm Ultra. Although these require repeating, they are safe and effective. Safety should be your first priority and all permanent fillers have a poor track record of long term safety in my opinion

Suzanne Kim Doud Galli, MD, PhD, FACS · Answer

Fillers are not an adequate substitute for Asian rhinoplasty. Typically Asian rhinoplasty is an augmentation rhinoplasty requiring the use of cartilage and/or synthetic grafts to augment the dorsum or tip. Permanent and adequate augmentation cannot be achieved with fillers especially in patients with very thick skin. Additionally, fillers such as silicone can cause permanent damage to the skin which may not manifest until years later. Even nonpermanent fillers may linger in the nose longer than in other facial locations, and the presence of the filler may interfere with surgical rhinoplasty.

David A. Bray, Sr., MD · Answer

If you want to obtain a good liong lasting result, surgery is your answer. Injectable silicone has a history of problems from infection to migration.

Jack Peterson, MD · Answer

Injected silicone has been extremely controversial for many years (even when I was in training 25 years ago). Due to significant long term problems that can occur - chronic granulomas and scarring- I would not consider injecting silicone for any reason.

Francis R. Palmer, III, MD (retired) · Answer

Do a quick internet search on complications from silicone injections and IMHO, you'll be motivated to do a Rhinoplasty instead. I typically use a straight silastic dorsal implant to raise the nasal bridge along with a conchal cartilage ear graft to shape the nasal tip during the Rhinoplasty.

Asian Nose-should I Go for the Non Surgical/surgical?

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