Non-surgical Rhinoplasty - is It Safe? Why So Controversial?

Nonsurgical Rhinoplasties are very safe if done properly with a well-trained surgeon.  Seeing a surgeon that understands nasal anatomy, and has experience operating on a nose, is the best way to start.  Next, find out if they use needles or a cannula to inject the filler.  Using needles for injection in the nose is what leads to problems and 'bad press'.  Cannulas are safer though experience with cannula injection is important.  Finally, find a surgeon who offers a multitude of fillers for your nonsurgical rhinoplasty.  Every skin type is different and creating a bridge requires a different filler than filling a defect or creating symmetry.  Thin skin utilizes a different filler than thick skin so having a variety of fillers to choose from is important.

Non-surgical rhinoplasty is a very safe procedure when performed by a qualified doctor. The controversy may stem from the fact that many people are skeptical that correction of the nose bridge can be done without surgery, although the results are not permanent. If you are interested in seeing a real- life example, I am including a link to a patient case from my office at the Dr.U Clinic in Los Angeles. The young lady has a nose-bridge similar to yours and achieved the straighter contour that she wanted with a dermal filler called Radiesse. She also has a video which you can watch.

A non-surgical rhinoplasty (nose job) is a quick 5 minute in office procedure which is performed with fillers to improve the appearance of the nose with zero downtime. I typically improve bumps on the bridge of the nose, make the bridge look more straight and narrow, refine the tip and turn the tip up a bit. The length of the result depends on which type of filler is utilized. 
Most surgeons, including myself, use hyaluronic acid (HA)  fillers such a Juvederm, Restylane or Voluma. The duration of each of this fillers is longer in the nose than those typically quoted, as it does not move as much as other parts of the face. Juvederm and Restylane-L typically last 9-12 months in the nose and Restylane Lyft and Voluma can last 1-2 years.  I have noticed that on occasion, less is needed over time and in some minor cases only a few times of injections caused a permanent change, perhaps by stimulation a bit of scar tissue to fill in the area.  A nice feature of the HA fillers is that there is a reversal agent that will reverse the filler right then and there if you are unhappy with the results (have never had to do this, but it is nice to know that it can be done). 
Blindness and skin necrosis (death of skin) because of decreased or blocked blood flow to the area is a feared risk of non-surgical rhinoplasty. Despite training and experience, which can reduce the risk, it is never actually zero. Luckily this is extremely rare, and when skin necrosis is treated correctly and promptly, it will can resolve. 
Some will use Radiesse, which is considered semi-permanent filler.  One issue with Radiesse is that there have been some reports of granulaoma formation (infammatory response) and it can make surgical rhinoplasty a bit more difficult in the future.  
For these reasons, I prefer the HA fillers and will use Lyft or Voluma if there is enough soft tissue coverage for a longer lasting result. 
Seek consultation with a board-certified rhinoplasty expert for an in person consultation for an examination and discussion of your surgical and non-surgical options. I hope this helps and best wishes. 

A non-surgical nose job can be a highly effective temporary solution for the right patient. Many patients do not have the down time or finances required for a surgical rhinoplasty. Like any medical procedure, a non-surgical nose job does have risks. The biggest risk is the potential for blood vessel occlusion during or after injection. This could lead to skin death or other issues if not treated properly. 
The biggest key with any potential risk is prevention. Through certain injection techniques and knowledge of the nasal anatomy, the risks can be minimized. This is why it is critical to find an injector who performs both surgical rhinoplasty and non-surgical nose jobs, as these physician injectors will be skilled at making the proper cosmetic nasal changes and doing so in a safe manner.
All the best,

I would consider this procedure to be safe as fillers can be reversible.  It is certainly less risky than traditional rhinoplasty.  However, it is important to carefully consider what you are trying to accomplish with the procedure.  Fillers by definition will augment your nose meaning they will add volume.  For large noses, reduction rhinoplasty, filler may not be the best choice.

Every procedure has a level of risk, and non-surgical rhinoplasty is not an acception to this rule.  Although rare, fillers can cause skin tissue necrosis, scarring and changes in the quality of the skin.

My recommendation is to see a rhinoplasty surgical specialitist who also performs non-surgical rhinoplasty to ensure you are an appropriate candidate.

Nonsurgical rhinoplasty can certainly be an excellent option for the right patients.  The advantages of this procedure include reduced downtime, ease of reversibility, and cost.  However, not every nose can properly be addressed through the use of fillers and Botox and the effects are often temporary.  Therefore I would urge you to seek consultation with a surgeon who is skilled at both surgical and nonsurgical rhinoplasty.  Through the use of computer imaging, you and she/he can decide upon your goals and objectives and determine the best approach.  The last thing I would add is that traditional, "surgical" rhinoplasty is an extremely safe and effective procedure with high patient satisfaction, when performed by a specialist in this type of surgery. 

Depending on your issue, you may be a good candidate for a non surgical rhinoplasty procedure with dermal fillers.  However, the nose drooping with smiling is due to depressor muscle action which would require a surgical procedure to correct.  

Hi jahans in Minnesota,

First, be very careful with any injections into the nose. The nose is very susceptible to color changes, discoloration, swelling, blood flow, pain, numbness, and other potential complications with inappropriate injections into the nose.

There isn't a filler on the market currently that is FDA approved for injection into the nose. Everything is being used off-label. Fillers should never be placed into the tip of the nose, since complications may more likely occur at the nasal tip. Fillers should only placed in the bridge to help smooth contour irregularities and to provide augmentation. Fillers which have been used for nonsurgical rhinoplasty include Radiesse and hyaluronic acids.

One non-surgical rhinoplasty option for you could be Botox Cosmetic. Botox may injected into the base of the nose in specific areas to help reduce the droopy tip when smiling. Results would be temporary, lasting a few months.

Depending on the specific anatomy of your nose and your desires, I suggest first speaking with a rhinoplasty surgeon who can use computer imaging to simulate rhinoplasty. You'll be able to visualize in real time what possibilities are potentially available. Only after a comprehensive in-person evaluation can a plastic surgeon help determine the appropriate options for you.

Dr. C

While I agree your nose is probably better off treated surgically, if you are not interested in having surgery I do believe you can achieve some improvement with a "filler nose job".  It depends on the skill of the injector, like any procedure, but based on your photo it looks as if the hump you have can be minimized with some filler placed above it and your tip can be improved with some filler placed in that area.  It won't be perfect but it is a small investment with bruising and some minor swelling as the only potential likely side effects, so it might be worth trying if you are adverse to surgery.