Whether referred to as 'nose filler', a 'liquid nose job', or a 'non-surgical nose job/rhinoplasty/reshaping', the aesthetic treatment promising to redefine the shape of one's nose continues to rise.
"More and more aesthetic practitioners are performing this procedure globally," says Dr Ashwin Soni, plastic and reconstructive surgeon and founder of The Soni Clinic. "They do, however, continue to be one of the highest risk treatment areas with filler, so choosing a highly qualified medical provider who has extensive knowledge of anatomy is imperative."
Here, Dr Soni and Dr Marco Nicoloso, an aesthetic doctor and medical director at Ouronyx, reveal all there is to know about how non-surgical nose jobs actually work, who they're best suited to, the results and the risks – plus, how to find a trusted practitioner.
How are non-surgical nose jobs performed, and how can they change your nose shape?
"This precise technique involves strategically using dermal filler to address nasal imperfections. Administrating small amounts of filler at multiple points including the bridge and tip of the nose can make it appear straighter and thinner [even if it isn't literally narrower], while improving the overall shape and side profile," Dr Nicoloso explains.
Who is the procedure suitable for?
Dr Soni adds: “A non-surgical rhinoplasty is suited to patients with a drooping nasal tip, or a bump – known as a ‘dorsal hump’ of the nose – that bothers them. The strategic placement of filler in a non-surgical rhinoplasty can improve the nasal tip, lift the tip, and straighten the side profile by correcting the bump.”
What does a non-surgical nose job procedure entail?
"There is an initial consultation to assess suitability and then discussion of the filler choice," says Dr Nicoloso.
"After we have cleansed, using a small needle we inject the dermal filler into the specific areas to reshape and enhance; adding volume, filling in depressions, or smoothing out irregularities."
Dr Soni adds, "There is a strategy in terms of the order of what part of the nose to start and end with."
The results are instant, he adds, "but I always advise my patients to wait a few days for the mild swelling to settle down. I personally see all my patients back for a follow-up at a month to see how it has settled out". Dr Nicoloso, too, welcomes all patients to return for an aftercare appointment to assess how the filler has settled.
What are the benefits of this treatment over traditional rhinoplasty?
Dr Soni explains: “We now have more and more options for performing non-surgical procedures. Being non-surgical it means less risk, less downtime, and fewer side effects. We can do so much in just ten minutes and with no pain. Surgical rhinoplasty, however, takes a month or longer to recover from and results are not always perfect.”
What else is there to consider when choosing between a surgical or a non-surgical rhinoplasty?
As a plastic surgeon, Dr Soni has extensive experience of doing both surgical and non-surgical rhinoplasties, which allows him the experience to be able to guide patients in the direction that works for their goals and particular anatomy. “The only way to really know whether you would be a suitable candidate for a non-surgical rhinoplasty or surgical rhinoplasty is to a consult an experienced provider,” he says.
In addition to the advantages of a non-surgical rhinoplasty noted above, there are some disadvantages to note: "You cannot make the nose narrower or slimmer, and cannot address any internal narrowing – and in those cases I would recommend a formal surgical rhinoplasty.”
What has influenced the rise of filler use to transform the nose?
"More and more patients are becoming aware of filler rhinoplasty, and so as this spreads across different platforms, an increasing number of people are booking in for one,” Dr Soni says.
“The rise of the selfie over the years, shared on all social media platforms, has definitely influenced the interest in non-surgical rhinoplasties," he adds. "Often these photos are taken at unflattering angles, and at that 45-degree angle, you can often see the bump or drooping nasal tip quite clearly."
Dr Nicoloso concurs. “The rise of social media platforms like Instagram and TikTok has definitely popularised this treatment. Many individuals are exposed to before-and-after photos, and transformations, which has generated interest and curiosity.” This, plus the benefits of the "short procedure time, minimal downtime and side effects (in terms of bruising), and it being relatively safe when performed by an experienced doctor," make it appeal to more people.
What happens if you don’t like the results?
Dr Nicoloso notes that "another benefit of having non-surgical rhinoplasty using dermal fillers is that it isn't permanent, and it can be dissolved using Hyaluronidase which breaks down hyaluronic acid, allowing for their removal or adjustment if you are unhappy with the shape and end result of treatment".
Is it simple to dissolve filler?
“It is possible to dissolve filler if you wanted to reverse the results, but you don’t want to do that unless it really is an issue,” says Dr Soni. “I have never had to dissolve my own filler in practice and would hope that I don’t need to as it can affect your normal tissues too, and does not just break down the filler. So yes, this is a reversible procedure, but dissolving can be avoided with a great discussion before you go ahead, and making sure that you fully trust the provider when you come out of that consultation.”
Does the procedure hurt?
Dr Nicoloso explains, "it can be slightly uncomfortable; however, we use topical anaesthetic so the area will be numb". Additionally, the filler used generally includes anaesthetic within it, which further numbs the area, so pain is considered to be tolerable. Dr Soni adds that he uses a number of ways in order to minimise discomfort, “from local anaesthetic cream to ice packs to the smallest needles I can use for the particular procedure”.
How long do the results usually last?
According to Dr Nicoloso, “The results last around 12-to-18 months, though some may require a slight top-up in between this timeframe.” Dr Soni finds that the results last on average between 12 and 24 months.
How safe is a non-surgical nose job?
Dr Soni feels that non-surgical nose jobs are safe in the right hands, but being one of the higher risk filler procedures, it is imperative to see the most experienced practitioner possible. “I use personally use the amazing quality Swiss filler brand Teoxane, which will metabolise and be broken down by the body naturally.”
What are the side effects and risks?
Some injection-related side effects can occur including redness, tenderness, swelling and bruising, but none of these are very serious and will resolve in a matter of days. But, as with all cosmetic filler, in addition, there is the risk associated with the filler itself. "On rare occasions filler can get into the wrong area, if this happens and there is filler in an artery it can cause a blockage so blood cannot flow through the vessel, giving rise to a vascular occlusion (blockage). This can lead to tissue death in that area known as necrosis which can eventually lead to blindness," explains Dr Nicoloso.
What regulation is there in the UK?
Dr Soni warns that there is a significant lack of regulation in the UK regarding aesthetic-based treatments and injectables. “Given that this is a higher risk procedure with filler, ensure you do your homework on your provider. One should look on the respective providers governing bodies to ensure that they have a medical licence to practice, for example the General Medical Council for Doctors (GMC) is a good place to start. Study their website and know where and what their training consists of. This is not a procedure that you want performed by a non-medical professional. There can be serious risks if the provider is not exceptionally well-trained, so please don’t pick a provider simply based on cost of treatment.”
How else to choose a reputable practitioner?
“Firstly, the number one priority is to research your chosen provider well,” Dr Soni reiterates. “Prior to embarking upon any procedure, it is important you have a lengthy discussion with your provider about what can realistically be achieved with a non-surgical consultation and whether you would be happy with that. Also, please study a provider’s 'before and after' photos to make sure that your aesthetic goals align with the types of results that they offer. You should also be aware of what the filler is that your provider is using, and ensure that it is hyaluronic acid based, and is the highest quality product. Finally, it is really important to check that a clinic or provider has an out of hours number that you can message or call in case of any issues. You should have a way of contacting that clinic if you needed to.”
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