A “liquid rhinoplasty” is the term used for changing the shape of the nose with filler. It is becoming an increasingly popular option and before and after pictures are prevalent on social media. To perform a liquid rhinoplasty, a filler (usually hyaluronic acid (Restylane or Juvederm) or hydroxyapatite (Radiesse)) is placed in the nose to camouflage a dorsal hump, improve tip shape, or create the illusion of a narrower, more lifted tip or bridge. This can be done in the office in just a few minutes with no down time. It sounds easy, but there are some risks. There is a risk of bruising, and sometimes patients can feel the filler under their skin and even move it around or mold it into place themselves. Filler placed incorrectly can embolize or travel into a blood vessel around the nose. This is extremely rare but if it happens it can cause necrosis (death) of the overlying skin or, very rarely, unilateral blindness. There are techniques injectors can use to minimize these risks but we can never completely eliminate risk.

A traditional surgical rhinoplasty involves cutting the skin on the bottom part of the nose between the nostrils (the columella) and inside the nose, and using shaving, molding, and grafting techniques to re-shape the nose. The recovery period generally lasts 1-2 weeks. Most swelling resolves by 6-12 weeks, but some minor residual swelling can last up to 2 years.

 

“Now that I understand the difference, which one should I choose?”

 

Choose a liquid rhinoplasty if:

 

You are ok having a slightly bigger nose. We are adding volume to the nose. There is no getting around the fact that it adds height to the profile or projection to the tip in order to achieve a more pleasing aesthetic.

You do not have time to be off of work or cannot afford to have any down-time. Aside from some slight bruising and swelling, there is minimal recovery from a liquid rhinoplasty.

You are not ready for surgery…yet. Filler in the nose generally lasts 1-2 years. It can be a bridge to rhinoplasty surgery. It can also allow you to “try on” how a differently-shaped nose would look or get used to a new aesthetic.

You go to a rhinoplasty expert. Rhinoplasty experts (facial plastic surgeons trained in rhinoplasty or dermatologists well trained in nasal filler injections) are well versed in the anatomy of the nose and understand the safest techniques and locations for injection.

 

Choose a surgical rhinoplasty if:

 

You need to improve your breathing. Liquid rhinoplasty does nothing to improve breathing through the nose. It only alters the external appearance. Surgical rhinoplasty involves internal nasal work that can open the airway and improve breathing while at the same time improving the nasal appearance.

You have had previous rhinoplasty surgery(ies). Rhinoplasty alters the blood supply to the nose and can increase the risk of nasal filler complications if a large amount of filler is injected into or around a blood vessel.

You want a smaller nose. As mentioned above, liquid rhinoplasty adds volume to the nose. Surgical rhinoplasty can actually remove cartilage and bone to make the nose smaller.

 

I offer both liquid and surgical rhinoplasties in my practice, so be sure to ask me about your options during your consultation!