Non-Surgical Rhinoplasty A Good Or Bad Idea?

By Shervin Naderi, MD FACS

Naderi Center for Cosmetic Surgery & Skin Care, PLLC

. https://www.virginiafacialplasticsurgery.com/

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Non-Surgical Rhinoplasty A Good Or Bad Idea?

In recent years we have witnessed a flooding of the market with new providers, products and procedures, promising amazing cosmetic results with minimal down time. The “Non-Surgical Rhinoplasty” fits into this category. So what is it and when is it useful?
The history of nasal surgery dates back thousands of years to India where Sushruta, devised techniques using forehead tissue to reconstruct womens noses that had been cut off as a punishment for adultery. Some of the principals used by those pioneering ancient surgeons are still utilized today for reconstruction of the nose following trauma or cancer. In fact, slight modifications of these ancient techniques gave rise to the para-median forehead flap, which is the cornerstone of all major nasal reconstruction.
John Orlando Roe, an otolaryngologist from New York, is accurately given credit for performing the first endonasal or “closed” rhinoplasty in the 19th century. He and the German orthopaedic surgeon, Jacques Joseph are widely regarded as the fathers of aesthetic Rhinoplasty and indeed the field of plastic surgery.
Rhinoplasty has since evolved into one of the most commonly performed cosmetic surgery procedures in the world. Properly performed, rhinoplasty in the hands of a well trained plastic or facial plastic surgeon should result in a beautiful yet, natural looking nose that highlights the intrigue of the eyes and enhances self esteem. The procedure takes about two hours or less, under anesthesia and the improvements are apparent as early as a week after surgery; although final results take longer to mold. The skilled rhinoplasty surgeon should be well versed in both the “open” and “closed” techniques of Rhinoplasty. rhinoplasty is the most humbling of operations, requiring a total lifelong dedication.
Non-surgical rhinoplasty is a new term for an office-based procedure where a provider injects fillers such as Restylane, Radiesse, Artefill, or even Silicone into the nose. This procedure is offered as an alternative to rhinoplasty to hide a bump, raise the tip, or create a linear profile. These procedures are usually offered by non-surgeons as a “quick fix.” Many patients are choosing this route in order to avoid surgery and save money. What they often end up with is a significant chance of distortion, infection and irreversible scars. As rhinoplasty surgeons, we believe that only autologous tissue such as cartilage and fascia should ever be used in the nose. Other substances will eventually become infected or extruded. Its just a matter of time.
The only situation where injection of a safe Hyaluronic acid-based filler, like Restylane, is acceptable is when used in small amounts to hide slight depressions on the nose, as a temporary correction prior to an actual rhinoplasty or revision rhinoplasty.
The trend in cosmetic surgery has been towards more expensive lasers and devices and less surgery and down time. Quick fixes are in demand. However, rhinoplasty is still one area where the proper tool is a sharp scalpel in the hands of a dedicated skillful surgeon.