In the last 2 years, requests for non-surgical rhinoplasty (“non-surgical nosejob”) have increased. This is due to the ease of having filler injections performed in the office without significant downtime or anesthesia, the reduced cost compared to surgical rhinoplasty, and the potential reversibility of the outcome. “Injection rhinoplasty”, “filler rhinoplasty”, and “non-surgical nosejob” are amongst the highest searched procedures on Google for those seeking improvement in their nasal shape and appearance.
I think it is important to look at the pros and cons of non-surgical vs. surgical rhinoplasty in detail. I perform both on a regular basis and like to have a candid discussion with my patients about what can and cannot be accomplished, including a review of potential risks.
Non-surgical rhinoplasty is a term given to using injectable fillers such as Restylane, Juvederm, Bellafill, etc… to change the shape of the nose. Topical anesthetic cream is applied for 10-15 minutes in the office, and the actual nasal injections take about 10 minutes to perform. Filler can be used to fill indentations, camouflage a hump in the nose, lift the nasal tip, improve tip definition, lower retracted nostrils, augment a nose that is generally too small, and improve certain asymmetries in the nose.
The results are immediate and can be dramatic for some individuals. There can be mild swelling and bruising, but this usually resolves within a few days. Most fillers are temporary, which means the procedure needs to be repeated in the future, roughly twice a year, but this depends on how quickly an individual resorbs the product. If you don’t like the aesthetic result, hyaluronic acid fillers such as Restylane and Juvederm products can be dissolved with hyaluronidase, an injectable dissolving enzyme. However, as with any procedure, there are risks to filler rhinoplasty. Although rare, there are specific dangerous risks such as blindness and skin necrosis that must be mentioned. Ultimately, it is up to the patient as to whether it is worth proceeding with filler rhinoplasty or not. If one does intend to pursue future surgical rhinoplasty, it is important that all filler is gone from the nose prior to surgery so surgical maneuvers and judgments can be made precisely. Sometimes, filler injections in the nose can trigger scar tissue formation that the surgeon has to contend with during surgery.
Surgical rhinoplasty is a procedure that has been performed for over half a century. It is an incredibly rewarding operation that allows one to accomplish more than can be done with injectable fillers. For example, a large hump may be camouflaged with injectable filler, but true reduction of the hump can only be accomplished by removal of tissue surgically. Nostrils can be reduced in size surgically, but not with injectables. Significant crookedness of the nose can be addressed more comprehensively in the operating room.
Generally, surgical rhinoplasty results in long term, lasting changes to the nose. However, surgical rhinoplasty requires anesthesia, downtime of 1-2 weeks initially, risks including but not limited to bleeding or nasal obstruction, and the possible need for revision surgery.
In summary, in my opinion, both treatments yield good results but surgery gives me the ability to treat more issues. For those individuals who seek very subtle, mild changes and who are willing to undergo treatments about twice per year, non-surgical filler rhinoplasty offers a very viable option. For those patients who are looking for more of a change and longer lasting results, surgical rhinoplasty is an ideal solution. With both procedures, complications are uncommon but worth being aware of. For an individualized recommendation, please call us at 239-594-9100 to schedule a consultation with one of our board-certified surgeons.
Anurag Agarwal, M.D., F.A.C.S.
Medical Director, Aesthetic Surgery Center