Liquid silicone (Silikon-1000), Artefill, and Bioalcamid are all permanent fillers, meaning they contain material that is foreign to the body (not natural) and hence cannot be broken down and eliminated by the body's normal systems. On the surface of things, it would appear that injecting a permanent filling material would be the ideal situation, since it would be a one time treatment. In fact, while the upside of a using a permanent, non-metabolizable filler is that it is permanent, the downside is that it is permanent. Meaning that if you don't like the results of treatment, these unwanted results are permanent. Permanent fillers cannot be dissolved away, nor, even with surgery that may leave scars, can they always be entirely removed.Now, even if we do get the desired result, it must also be remembered that what might look great today may look awkward, bizarre or strange one, five or ten years down the road when age-related changes take place around the injected material. In addition, there have been many reports of granuloma (bumps and lumps) formation at the injection sites that have occurred as long as twenty years after injection--reactions that are very difficult to treat. I have personally treated several patients like this who received permanent fillers in Europe many years earlier. For this reason, after fifteen years of experience performing nonsurgical rhinosculpturing, I suggest the use of semipermanent volumizers for nonsurgical nose jobs, such as Radiesse alone or in combination with Voluma (in my Upper East Side Manhattan practice) and Radiesse alone or combined with Resylane SQ (in my Israel practice where this agent is regulatory agency approved). The Radiesse is biodegradable with time and the hyaluronic acid products can be immediately be dissolved with hyaluronidase should the need arise. My suggestion is be wary of permanent fillers; they are foreign to the body, and follow the KISS philosophy--i.e. keep it simple by using safe and proven semipermanent volumizers that allow for relatively long-lasting improvements, reversibility, and little concern for late developing granulomatous complications..And of course, only seek treatment at the hands of a board certified core physician with extensive experience in performing nonsurgical rhinoplasties.
