Am I possibly a candidate for Nonsurgical Nose Job? (photos)

Question

My original plan for 2022 was to get only a chin implant and submental lipo - however, recently, I'm intrigued by the possibility of improving my nose as well. I want to avoid surgical rhinoplasty if possible and am curious if I may be a candidate for nonsurgical nose job, or if my dorsal hump is too big? I'm including a photo - the left image is my current side profile, the right photo is a rough mock-up of what I'd like to achieve via chin implant, submental lipo & nonsurgical rhinoplasty.

Donald Groves, MD · Answer

Hello and thank you for your question and the pictures. Addressing the shape of your nose (especially the dorsum) is actually one of the most common reasons people seek out and undergo a rhinoplasty. Unfortunately, there are no good non-surgical approaches which would properly achieve what you're looking for since your radix and dorsum are already high (and the ones that exist- e.g. nasal filler- carry the risk of blindness)! An open septorhinoplasty can best address both your aesthetic concerns and any functional issues with your nose. I would be able to adjust the size, shape, and definition of your nose (particularly the dorsal)!

It also appears you have a "weak chin" relative to the rest of your facial features- the best way to properly address this is with a chin implant to improve the overall harmony of your facial features, especially from your side profile. It's actually pretty common to need both procedures instead of just the rhinoplasty!

Rhinoplasty truly is a surgery of millimeters- and whether you're looking for a minor adjustment or a major transformation, it requires exceptional surgical skill to achieve functional and natural-looking results! Because your nose is the DEFINING feature of your face- I would only recommend seeing a surgeon who specializes in rhinoplasty procedures, and who has significant training and experience performing these surgeries. I actually trained under one of the world leading rhinoplasty experts (who performs 1,000+ nosejobs annually). I also trained under a world-renowned master of complex facial aesthetics!

I recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with both rhinoplasties and chin implants) to thoroughly discuss your surgical goals, undergo a formal examination, evaluate your options, and develop a personalized plan just for you. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Jason Emer, MD · Answer

Hello and thank you for your question. Honestly, surgery is the best option to address your dorsal hump and refine the size and shape of the nose, as in your situation. Filler can help partially mask the hump, but would not fully achieve your goals, particularly because you have a high radix. Also, filler would only be temporary in nature. The shape of your nose is due to the underlying anatomy present- a combination of your nasal bones and cartilage makes up the structural framework of your nose, including the support for the dorsum and the tip. Addressing the shape of the nose (especially the nasal dorsum and nasal tip) is actually one of the most common reasons people seek out and undergo a rhinoplasty procedure. This would provide optimal results to achieve your goals, especially if you are already considering other surgery, as this could all be performed at the same time.

In addition to addressing your aesthetic nose concerns, your septal cartilage (or an off-the-shelf alternative) would be harvested (removed) and turned into multiple cartilage grafts, which would then be secured into different areas of your nose for structural support, including in the columella (middle bottom portion of your nose between your nostrils) to really reinforce the tip and prevent long term alterations/distortions to nose shape.

The open approach is very effective in facilitating complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look. Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery. I would only recommend going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible.

Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the photos and description provided.

Dr. Donald Groves, our expert facial plastic surgeon, has extensive training and experience with complex rhinoplasty surgeries, so I’d recommend for you to come see him (or another plastic surgeon who is extremely comfortable with rhinoplasties) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!

Dr. Emer

Eric M. Joseph, MD · Answer

Based on your photo, you appear to be a suitable candidate for Chin implant surgery and neck liposuction surgery. I suspected after that procedure is performed, your nose will be less distracting. At that point, you could consider a non-surgical nose job to camouflage your small dorsal hump. I hope this is helpful! Sincerely, Dr. Joseph

Donald B. Yoo, MD, FACS · Answer

Nonsurgical rhinoplasty would be able to create a straighter profile and frontal view for your nose. The limitation with nonsurgical rhinoplasty is that it can only add volume, but can not take any away. By slightly raising the bridge of your nose above the hump it will camouflage the hump. A rhinoplasty specialist will be able to comprehensively address the issues you have with your nose. While there are a variety of approaches and techniques employed by various surgeons, it is up to you to do your due diligence to find a rhinoplasty specialist in order to achieve the best results possible. Good luck! @drdonyoo

Inessa Fishman, MD · Answer

Nonsurgical or so-called "liquid" rhinoplasty involves the use of dermal fillers to reshape the nose, and one of the most common treatment goals of this treatment is to camouflage a dorsal/ bridge hump.  Dermal filler is placed above and sometimes below the bump in order to create the appearance of a straighter bridge.  The photo you have shared shows a nose that would likely do well with a nonsurgical rhinoplasty in achieving this aim.  
Because the nose is a higher risk area to treat with filler, you'd be well served by seeing an expert injector who has a lot of experience with nose filler and is comfortable managing the complications of this treatment.  Best of luck!

William Portuese, MD · Answer

In our practice, we do not recommend non-surgical nose jobs because are only temporary, are not FDA approved for that application, and can have significant complications such as skin necrosis. Consider performing closed rhinoplasty to shave down the dorsal hump, reduce the overall projection of the nose refine the bridge line and nasal tip with all the incisions placed on the inside of the nose. Placement of a chin implant can augment the chin forward for better facial balancing portions, especially from the side profile with respect to the overly projected nose.

James Fernau, MD, FACS - Account Suspended · Answer

Hello,

Thank you for your question. This is Dr. James Fernau from Pittsburgh, Pennsylvania. I believe you would be a great candidate for a liquid rhinoplasty and could expect those results in your photoshopped image. This is performed by placing filler into the bridge of the nose in order to straighten it. Placing filler into the tip will not mechanically raise it; however, it can be strategically placed in order to camouflage a drooping nose. Topical numbing is applied prior to the procedure so patients usually experience no pain. This procedure should be done by a board-certified plastic surgeon. I recommend a consultation with a board-certified plastic surgeon to determine the best plan for your desired results. Thank you and best wishes. Sincerely, James Fernau, MD FACS

Am I possibly a candidate for Nonsurgical Nose Job? (photos)

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