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Dr. David Mabrie: Hello, I am Dr. David Mabrie, a board certified facial plastic surgeon here in San Francisco. I'd like to share some information with you about nonsurgical rhinoplasty. One of the more common requests that I receive from my patients is to treat the nasal tip and in treating the nasal tip, it's important to actually treat the area above the tip, making sure there is no fullness there and in fact making sure that there is a smooth contour of the entire nasal profile. This is something that we do frequently with surgery. One of my patients that had a small hump or irregular contour and her tip looks better partially by treating the fullness above the tip and partially by treating the bridge. In other cases to make the tip look nice, she'll have to raise the bridge and the idea is the same to have a smooth contour that has an attractive nose.
We can now do this without surgery and this is a patient who had a nonsurgical rhinoplasty. We treat it as curved profile and droopy tip with fillers and this is the result that he was able to get. We see him here five minutes after having fillers to the bridge and the tip. On frontal view, you see that his bridge is stronger. It's more narrow and the tip is more defined. An attractive nose on the frontal view should have a smooth contour from the eyebrows leading down to the tip, which should be defined and proportionate. This young lady had a wide bridge and a wide nasal tip and we can see here right after treating her nonsurgically with fillers and her bridge is improved. The tip is improved. On three-quarters view, we can see that the tip actually looks smaller and more defined and what she had as an undefined super tip fullness has now been repaired and her nasal profile is more attractive. One of the major differences between surgical and nonsurgical rhinoplasty is the procedure time with the surgery taking about four hours and the fillers taking about 15 minutes.
How about recovery? This is a patient of mine that had a surgical rhinoplasty to narrow her bridge and improve the tip. We see her here at five days when the bandages are removed and now at two months when we are starting to see some of the results of her rhinoplasty. I advise most of my patients with surgical rhinoplasty to take a week off of work. This is patient that had some fullness and flatness of her nasal tip and we see her here immediately after having fillers placed in the nose with some redness and discoloration, and we see her the next day where most of her discoloration has resolved, so the recovery from nonsurgical rhinoplasty is about 10 minutes as compared to seven days for a surgery.
Susan: Well, I had a nonsurgical rhinoplasty with Dr. Mabrie and it was really simple and very straight forward. I'm really happy with the result. They are subtle but I can notice them and I really like the way that my nose looks now.
Dr. David Mabrie: Our goals for shaping the nose are the same with surgery and with fillers who want to improve the contour of the nose, making the nose and therefore the face more attractive. Traditionally with surgical rhinoplasty, we alter the contour by altering the anatomy under the scan, reducing the bones, cutting the cartilage and repositioning it. The difference with nonsurgical rhinoplasty is that instead of altering the anatomy, we are actually adding to the anatomy, filling in concavities and contouring with fillers. What are the fillers and how do they work? The fillers that I use for nonsurgical rhinoplasty are gel substance, normally found in the skin and they were FDA approved in 2003. They are clear jelly-like material that is well accepted by the body and it will last in the body for about a year and is slowly dissolved into water and absorbed by the body. Patients will come in at six-month intervals for treatments. In our office, we use the fillers for contouring the nose and the face, so we use these for filling in concavities in the tear trough area. I use them for contouring the face and cheek area. I do a lot of contouring with surgery and for the chin we use either fillers or chin implant.
In summary, nonsurgical rhinoplasty is a technique using fillers to improve the shape of the nose by contouring it. Both the bridge and tip maybe treated. The procedure takes about 15 minutes and is repeated at six-month intervals.