The LIQUID NOSE JOB (a.k.a. non-surgical rhinoplasty, non-surgical nose-reshaping and filler rhinoplasty) has been around for many years and could hardly be called a "breakthrough". From its comical but dangerous and painful beginning as injection of liquid paraffin to correct saddle nose deformities, it is now the perfect procedure for those who don't consider surgery an option. Its current popularity is due to the wide range of fillers available and the improved techniques of surgeons.
Simply put, the surgeon achieves a more regular contour by injecting the irregularities with filler, such as the hyaluronic acid based Voluma. The effect can be sutble or dramatic. The injector can create optical illusions like a slimmer and more refined nose, or a more empahsized projection.To be honest, total re-shaping can only be achieved surgically but tweaks such as:
- smoothening of the contour so that "camouflaged" bumps are less noticeable,
- lifting the tip of the nose so it looks more youthful,
- filling depressed sections so the nose contour looks more regular,
- raising the "nasal septum" (specially among Asians)
- correcting saddle nose deformities, and
- correcting minor assymety are possible.
Hyaluronic based fillers like Juvederm (including Voluma), Restylane and Belotero are soft tissue fillers which become putty in the hands of skilled injectors and can keep clients happy for nearly two years. The typical procedure takes about 50 minutes and consumes one syringe of the chosen filler. You can expect slight discomfort, redness and swelling upto two weeks. Downtime is so minimal that you can get back to work right after having the procedure - a true "lunchtime" treat!
At the risk of bursting your bubble, this is a procedure best left in the hands of skilled professionals. It looks easy but it demands expertise on nose anatomy, particularly blood vessels and innervation. It is safer than surgical nose jobs since it does not require general anesthesia and offers less downtime. The caveat is that it is not effective for cases like deviated noses or medical conditions like breathing problems.
The American Academy of Facial Plastic and Reconstructive Surgery AAFPRS) considers safe the most popular hyaluronic based fillers like Juvederm (including Voluma), Restylane and Boletero . Hyaluronic acid itself it naturally produced in the body and in cases where a bump develops, this can be dissolved by hyaluronidase, an enzyme that specifically dissolves hyaluronic acid. These fillers are soft, have less tendency to be lumpy and can last for two years. With a wide range of products that differ in density and flexibility, the skillful surgeon can customize what the client needs. All hyaluronic acid based fillers have the tendency to promote collagen formation in the area so there may be some residual effects past the two year expected lifespan of the filler.
Radiesse, calcium microspheres (CaHA), FDA cleared for the hands and face is a bit controversial for use in liquid nose jobs. It is intended to produce collagen, resulting in immediate and long-lasting volume augmentation but has been found to be shorter-lasting and with a tendency to calcify. It's high density is better for sculpting but unlike hyaluronic acid based injectibles, it is not reversiblle (can't be dissolved by hyaluronidase).
Other fillers like silicone, polyacrylamide, and other synthetic ones are discouraged because they resulted to more complications in the past such as disfigurement, calcification and skin necrosis.
The decision to have a liquid nose job to match you aesthetic goals begins with a thorough consultation with experienced and highly skilled professionals.