Permanent Filler for Non Surgical Nose Job?

Question

Well, I really want Rhinoplasty, but unfortunately I don't have the money. However, I am aware of the non-surgical nose jobs, but they only last 6-8 months.I really am considering the non-surgical nose-job because it is less expensive, but I do not have enough money to go back every six months. Therefore, I was wondering if there was a permanent filler, and how much would that cost? Thank you.

Jacob Sedgh, MD · Answer

The application of fillers to the nose, otherwise known as non-surgical rhinoplasty is not a real substitute for surgical rhinoplasty. Even though it can have a role in addressing some cosmetic issues that can improve by "camouflage" or "augmentation" techniques, it still carries a rare but major complication profile, including necrosis (part of the issue dying) or blindness, without a definitively known mechanism yet. In cases of suboptimal cosmetic results, when done with temporary fillers of hyaluronic acid based types, such as Resylane or Juvederm, it can at least be modified or dissolved, but a permanent filler such as Silikon or Artefill can cause a major issue, way beyond the scope of financial concerns.

Ozge Ergun, MD · Answer

Based on your info, you are a better candidate for surgical rhinoplasty. I advise you to discuss this with your board plastic surgeon, check actual before & after photos ( not the ones made with computer animation programs). 
The price of Rhinoplasty surgery depends on several factors such as the difficulty of your case and your request for your new nose. 
In my practice, prices for Rhinoplasty surgery reaches from 1900 Euro up to 4000 Euro range. I wish you all the best.

Matthew Richardson, MD · Answer

I do not perform or recommend permanent filler injections for a non-surgical nose job. There are several reasons for this. First, if the patient is unhappy with the results, there is no way to effectively reverse the injections. Secondly, every procedure has risks, and if there are any side effects or complications from the injections, there are (again) no ways to reverse the injections.
I use hyaluronic acid-based products because these are very safe, long-lasting, and reversible. The newer hyaluronic acid-based injectable fillers usually last much longer than 6 months in the nose. I often tell patients that they can expect 18 months or more, depending on the product that we use and the individual's metabolism. Non-surgical nose jobs are great for patients who are opposed to surgery or simply don't have the budget or down time, but patients who desire permanent changes to the nose should consider rhinoplasty surgery.
Be sure to see a physician who specializes in both rhinoplasty surgery and non-surgical nose jobs in order to review the procedures in detail. Remember that non-surgical nose jobs are advanced techniques that should not be performed by novice injectors.
All the best,

Young R. Cho, MD, PhD · Answer

Thank you for your question.  Not everyone is a candidate for a non-surgical nose job, but if you are, it can provide some really nice lasting results.  The duration of the procedure is based on the type of filler you use and the suppleness of the skin.  I do many non-surgical nose jobs in both patients who have residual asymmetry from surgical rhinoplasties or with a history of trauma.  I find that the scar tissue makes the expansion of the skin more challenging as the skin tends to push back on the filler.  For this reason,  I tend to use stiffer fillers such as Voluma.I find that the duration is longer for patients who don't have any history of trauma or surgery on their nose.  For those with scar tissue, I find that the results seem to get longer with each successive treatment.I would make sure you go to an experienced injector who understands the anatomy and can discuss with you both surgical and non-surgical options.

Rupert Critchley, MD, MRCGP · Answer

Hi there! I would certainly recommend non-surgical rhinoplasty using hyaluronic acid based dermal filler so you can get more of an idea first about whether you would be happy to proceed to permanent filler. Also it's nice to know that they are fully reversible. Non-surgical techniques can be used to improve contour / shape and tilt the tip of the nose. Personally I provide a 2 week check up and often do 'layer the product' as this ensures more result longevity. I see most of my clients for this procedure once a year. Hope this helps and best wishes,Dr Rupert

John L. Burns Jr., MD · Answer

Bellafill is a semi permanent filler which works very well in the nose.  It is FDA approved for 5 years although it theoretically should last as long as the PMMA microspheres.

Raffy Karamanoukian, MD, FACS · Answer

Permanent fillers are difficult to reverse and for this reason, many doctors do not advocate their use on the nose. Best, Dr. Karamanoukian

Jamil Ahmad, MD · Answer

Soft tissue fillers can be used in certain situations to correct deformities of the nose. One of the more common uses is to augment the dorsum (enlarge the bridge). There are some deformities of the nose that cannot be corrected or improved by soft tissue fillers. Careful analysis and evaluation of the deformity requiring correction is key. If the problem is that an area is too small, then fillers can be used to add volume and improve the overall appearance. However, if an area is too large or prominent, then addition of fillers around the area to attempt to mask the prominent area will create a nose that is disproportionately large. In this case, rhinoplasty for reduction of the area is more appropriate.  There are several important considerations when using soft tissue fillers in the nose to improve safety and prevent both short and long term complications. Use temporary fillers NOT permanent (Silicone, Artecol, Artefill). All synthetic, permanent fillers are fraught with disastrous complications including chronic granulomas and infections that cannot be corrected and cause awful deformities. Use gel fillers NOT particulate (Radiesse, Sculptra). The amount of filler injected at one time must not be excessive as this can cause problems with not only the appearance but also the blood supply. Hyaluronic acid fillers are ideal for injection into the nose as they are temporary (usually last for over 1 year) and gel. Additionally, if too much filler is injected or there are problems with blood flow to the nose, an enzyme (hyaluronidase) can be injected to dissolve the product and reduce the risk of skin loss and scarring. Both Juvederm and Restylane are commonly used hyaluronic acid fillers. If you want a permanent result, then you should also consider rhinoplasty surgery. You should discuss all of your options with your surgeon to decide what best for future treatments.

Eric M. Joseph, MD · Answer

A Non-Surgical Rhinoplasty (Nose Job) involves using Injectable Fillers in your nose to improve your facial appearance. You can have Silikon-1000 for permanent results (my personal preference), but Radiesse, Juvederm, and Restylane can also be used. The choice of filler depends on the preference, and experience of your physician. I have been personally using Silikon-1000 in the nose for over 10 years and have had wonderful success, and many happy patients.
Your Non-Surgical Rhinoplasty can be performed to camuoflage a small nose-bump. For example, you may have a bump on your profile view. Filling above and below the bump will improve your profile so it&rsquo;s straight and attractive.
Your crooked nose can also be corrected with a Non-Surgical Nose Job. If you have a depressed, concavity on your front view, it may cause your nose to appear twisted. Filling the concave area can lead to a straighter, more attractive appearance that won't call attention to itself.
If your nose has visible imperfections after a previous Nose Job, you can have this corrected permanently with a Non-Surgical Rhinoplasty. Repairing Rhinoplasty irregularities without additional surgery and downtime is one of the most rewarding procedures for my patients and me. I correct most Rhinoplasty imperfections with a non-surgical approach.
You can have imperfections in your bridge, tip, and nostrils restored to a completely natural, unoperated appearance. Visible, asymmetric tip cartilage can be camouflaged with Silikon-1000. A pinched tip can be corrected, and high nostrils can be lowered. A wide bridge can be narrowed if it's not too high. All while avoiding additional surgery which is inconvenient, costly, and often unnecessary.
Your Non-Surgical Rhinoplasty is performed painlessly with topical anesthetic. You have no downtime, and normal activities are resumed immediately after this 20-minute procedure. If you&rsquo;re an appropriate candidate for Silikon-1000, results are completely natural and permanent.
You may need Rhinoplasty Surgery if your airway and septum require correction. You may also require Rhinoplasty Surgery to make your large nose smaller since adding volume will only make things larger.
I've attached a link to my Non-Surgical Rhinoplasty photos for your perusal.

David C. Pearson, MD · Answer

Fillers can only address specific narrow problems with nasal shape, but for those patients who can be treated this way, I prefer Artefill (a permanent filler) for such patients. Generally, though, I like to start with a temporary filler like Juvederm so that the patient can "try it on" so to speak. If they like that result, then Artefill becomes a reasonable option.
All the best,
--DCP

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