Hi Lily,A common procedure for Asian patients is to raise the bridge of the nose. This gives Asian faces which are rounder and relatively flatter than our Caucasian counterparts more definition.Raising the bridge of the nose is called Augmentation Rhinoplasty when it is performed as a surgery, and Injectable Rhinoplasty or Non-surgical Rhinoplasty when performed using injections to add volume to the bridge of the nose.There are two types of injectable procedures. The most popular injectable is called Botox, which you referred to in your question. This first type of injectable is a toxin or poison which is used in very tiny doses to temporarily paralyze muscles which are "overused." You do not have any wrinkles on your face to warrant any Botox, which is why I suspect you were referring to injectables in general as opposed to Botox specifically. Botox is used for people who are frowning, raising their eyebrows or have fine lines at the corners of their eyes called "crow's feet," all of which you do not have as a young woman.The second type of injectables are called fillers. These fillers are a type of gel or paste which is injected under the skin. This filler will add volume to an area under the skin. We use injectable fillers for smile lines, adding volume to the cheeks, as well as injecting it on the bridge of the nose to add definition by raising the bridge of the nose. On the profile view it can give a person who has a very flat bridge a higher bridge. The limitation for the injectable fillers is that it cannot raise the tip of the nose. Adding filler to the tip of the nose will not make it pointier, instead it will make it a little bit puffy, and if a lot of filler is added to the tip, it will make the tip wider.In general, Asian patients who have the best improvement with a Injectable Rhinoplasty have a low bridge which starts lower than their upper eyelash line. If the bridge appears to start at the middle of the eye or pupil line, the filler can be added to the bridge of the nose to make the bridge start a little bit higher. Based on the only photo which you posted, it already appears that your bridge starts at your upper eyelash line. It is my personal opinion that Asian noses which start at the eyebrow line appear "fake" to me as a fellow Asian person. Even most Caucasian noses do not start that high, unless they have a prominent brow and deep set eyes. On a profile view, the bridge of the nose should appear to begin at the upper eyelash line for an Asian or for that matter most Ethnic noses which tend to be rounder or flatter with less definition to the tip. A bridge that is too high in Ethnic noses, screams nose job in my mind. I don't know how other surgeons feel about it, but I would rather not perform the procedure if it looks fake in my opinion.If the tip cannot be raised or projected further out, then an already straight Asian nose which starts at the upper eyelash line and goes straight to the tip will not be able to be improved. If the upper part of the bridge is scooped and lower than the upper eyelash line, then there is room for improvement with the injectable rhinoplasty technique.To raise the tip of the nose then add definition to the bridge with an implant or cartilage to narrow the width of the bridge would require a surgical rhinoplasty, which is not achievable with injections.In general, injectable fillers like Restylane and Juvederm last around 4-9 months before the patients ask for a Touch up. Longer lasting fillers like Radiesse, may last up to a year or sometimes longer, but there are risks with these type of fillers. Lastly, there are permanent fillers like Artefill or Silicone, which can cause permanent damage to the skin (Google: "Dean Toriumi and Nasal Injectable Fillers Causing Damage" to learn more about the potential risks.)The safest fillers if you were to choose to have this done would be hyaluronic acid type of fillers such as Restylane or Juvederm. These can be completely dissolved, where Radiesse or Artefill cannot be dissolved. If you like the results of raising the bridge of the nose, but additionally want a narrower tip and more definition, it may be a good way to "test out" how you feel about changing the appearance of your nose. If you really like it, you can first dissolve away the Restylane or Juvederm, then have a consultation for a rhinoplasty without the filler in anymore. If you have Radiesse, and it cannot be dissolved, a rhinoplasty can be performed, but later as the filler goes away, the bridge may not be high enough as some of the result was temporary. As you can see, choosing injectable rhinoplasty should not be taken lightly, especially if you choose something which is not dissolvable. In the 1980's, injectable rhinoplasty was a common procedure in Asia, and they were using silicone. Although many patients looked great initially, the permanent silicone gel did not stay on the middle of the nose, and began to shift or slide to the sides of the bridge which make the nose not only flat but even wider than before the silicone injections. Some doctors claim to have invented injectable rhinoplasty, but they may not be aware of the past history of injectable rhinoplasty, and these same doctors are recommending longer lasting and permanent fillers which seems to be the case of, "those who don't know history are doomed to repeat it."Most likely I would not recommend any injectable filler to your bridge, but if your side profile were somehow below the upper eyelash line, or you wanted it slightly higher than the upper eyelash line, but below the eyebrow/forehead, you would most likely use a 0.5 cc syringe or half of a syringe, and potentially not even use the whole amount. I typically inject smaller amounts and let the patient look in the mirror, before deciding to inject more and make the bridge even higher. This way it is hard to over inject or make the patient look plastic or ridiculous.I hope that you find this answer helpful. Good luck on your cosmetic journey.Best,Dr. YangP.S. There is a new feature on Realself, which is the "Follow" button. It is similar to the "Like" button on Facebook. If you like my response or any of the doctor responses while you research on Realself, you should "Follow" them. You will get email updates, when the doctors you follow post any new answers to questions, post new photos, or have any new reviews.
