Are there any non-surgical procedures to make my nose smaller, or is surgery my only option?
Non-surgical Nose Job Procedures to Reduce Nose Size?
Doctor Answers 72
Non surgical rhinoplasty isn't for big noses
Unfortunately injectable rhinoplasty by its very nature can't make your nose smaller. Very occasionally a 'liquid rhinoplasty' can create the illusion of a smaller nose, but this is rare. Injectable rhinoplasty is for creating straighter nasal bridges, straightening slightly bend noses and for 'touch ups' after rhinoplasty.
Non surgical rhinoplasty
Non-Surgical Rhinoplasty for the Big Nose
Technically it is not possible to reduce the size of the nose with a "non-surgical" rhinoplasty. However, a non-surgical rhinoplasty can make some noses look smaller. Some examples of change the shape to create the appearance of a smaller nose:
1. A nose with a deep radix and a large bony hump.
2. A nose with an deep angle between the upper lip and the bottom of the nose (acute naso-labial angle).
Based on the one profile photograph, I would recommend an endo-nasal reduction rhinoplasty. However, in general it is best to consult a Board Certified Plastic Surgeon for more specific advice and photo-morphing to obtain the best results.
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Nonsurgical Rhinoplasty: Benefits and Limitations
Injecting fillers, such as Restylane, Juvederm, and Radiesse, in the nose can be helpful for certain patients who would benefit from additional volume in certain specific areas. Adding filler can cause certain noses to appear less deviated, improve symmetry, and fill indentations after prior rhinoplasty. Sometimes, adding filler above a hump can make it appear less prominent.
However, there is no nonsurgical way to make a nose smaller. I would recommend that you seek consultation with a surgeon who performs both traditional (surgical) rhinoplasty as well as nasal fillers. That way, you would have access to all the different options out there for your nose. Computer imaging is a very valuable exercise during the consultation, for you to express your aesthetic goals and for the surgeon to express what she/he could do with fillers vs. rhinoplasty. Lastly, from your photo, it appears that you may benefit from a chin implant as well, as a more projecting chin will make your nose appear more balanced with the rest of your face.
Non Surgical Rhinoplasty
Reducing nose size
In the case of a slightly larger nose and a short chin, increasing chin projection with an implant or a sliding genioplasty will help to improve facial harmony even if a reduction rhinoplasty cannot be done at the time.
Non-surgical Nose Job Procedures to Reduce Nose Size?
There are different kinds of rhinoplasty operations however we can divide them as the one that requires bone excision and the one that does not need bone excision. The main fact that we classify the rhinoplasty operations like that is that the results and postoperative period is associated closely with this fact. In the operations like “nasal tip correction”, “simple rhinoplasty” there is no need for a bone excision however these minor operations cannot be beneficial for everyone. The operation type is need to be determined by the surgeon according to needs of the patient. In these minor operations the rhinoplasty is performed with closed method. The bone and the cartilage tissues are not involved in the surgery directly. Small nasal bumps can be removed in these operations.
In the operation that needs the bone and cartilage tissues to be involved; open approach is used. In the procedures with open approach, the size, shape and functionality of the nose can be improved. The big nasal bumps can be removed and septal deviations can be corrected providing a better nasal airway.
The only non-surgical treatments that can change the appearance of the nose are injectable fillers such as Restylane or Juvederm. However, by their commonly used name of “fillers”, you are increasing volume with a filler. What is interesting is that the aesthetic appearance of an attractive nose can be broken down to a great degree to ratios, proportions, and trigonometry. Something our brain subconsciously does when we meet someone and think if they have an attractive or unattractive nose. Fillers give us the ability to manipulate some, but not all, of those factors in changing in how the nose appears. Specifically, adding volume to change proportions, etc… can actually change the mind’s eye perception of the size of the nose. Most commonly, patients who have a bump on the bridge (dorsum) of the nose, or those who have an excessive depression (acute angle) where the bridge of the nose transitions into the forehead are ideal candidates in which adding literally drops of a filler in the skin of this area will actually create more ideal angles/proportions, resulting in a more attractive nose even though it is actually slightly larger now.
However, although extremely rare, it is well documented in the medical literature that blindness can occur when used in or very near the nose. There are different hypothesis as to why this has occurred, but no agreement/consensus as to why, or more importantly how to prevent it. Therefore, although very rare and random, correction of nasal deformities with fillers should be approached with this risk in mind.
If the decision between you and your surgeon is to go forward with a filler in the nose, it is very important to know what type of product is being injected. Radiesse is not ideal in this situation since it can cause significant inflammation and result in scarring of the soft tissues to the underlying cartilage/bone. Scarring in the plane of tissue between the cartilage/bone and the overlying skin creates very dense scar tissue making elevation of the skin very difficult with high risk of injuring the skin or underlying structures. I have performed several revision rhinoplasties of other surgeons in which this product had previously been used to camouflage contour irregularities postoperatively, and each time was faced with this issue.
A much more ideal type of injectable substance is hyaluronic acid, and typically Restylane or Juvederm are used in the situation. These products don't typically last much longer than 3 to 6 months especially when placed around the mouth. However, they will usually last an average of 9 months in the nose since there is any real active muscles in or around the nose to pull on the nasal skin which would result in friction and increase the speed of breakdown of the product. Because of the relatively short duration of the correction, to consistently maintain the results that are achieved, correction with repeated filler treatment will end up costing much more than surgery which is permanent.
Finally, if you have very thin nasal skin, placement of hyaluronic acid can result in the Tyndall effect. When light passes through a clear liquid such as water, all the wavelengths of light (all colors of the rainbow) pass through giving the water no color. However, when very fine particles are in suspension of a clear liquid such as water, (think flour in water which can demonstrate this) the water takes on a slightly blue hue because blue’s wavelengths are shorter, and therefore are reflected by the suspended particles and therefore seen. The longer wavelengths are able to pass through and therefore aren’t trapped to be seen. Hyaluronic acid placed too superficial in the skin, or just placed in thin skin cause the skin to have a slightly blueish hue.
Given all of the above, I generally tend to steer patients away from this option in reshaping or correcting a previous rhinoplasty.
Hope you found this answer helpful. All the best!
A reduction rhinoplasty is not obtainable with non-surgical modalities
Thank you for your image, and question. I find this to be a common question. While I have seen some dramatic improvements with non-surgical modalities, a reduction rhinoplasty is not a contour procedure.
In order to achieve a reduction in size, an operative procedure is required since this is a subtractive procedure, not additive as adding a filler is.
Sergio P. Maggi, MD, FACS
Austin Plastic Surgery Center
Non surgical rhinoplasty
It may sound counterintuitive but, adding filler to the nose can give the appearance of making it smaller. Obviously injecting a filler into the nose will add volume to it. However, if the product is placed in discrete amounts, in the right areas, cosmetic improvement is very attainable. Whether or not this would benefit you would require a careful exam of your nose by a physician versed in fillers in this very delicate region.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.