Nose Reshaping

Created on 10th July 2009

Mr Christopher Inglefield, of London Bridge Plastic Surgery, explains how temporary fillers have made it possible to offer a non-surgical alternative to rhinoplasty

The nose commands a prominent position in the aesthetics of the face and it is therefore no surprise that rhinoplasty is one of the most common cosmetic procedures performed. How the nose compliments other features such as the chin and forehead, impacts on the whole aesthetic balance of the face. 

Even minor deformities or imbalance of the nose can have significant effects on the facial appearance such as the subtly elevated nasal tip implying youth, whereas the long drooping tip signifies ageing. Racial variations must also be considered and respected in planning any treatment.

It is important in assessing a potential rhinoplasty patient that a complete assessment of the entire face is performed before a treatment plan can be agreed to achieve the optimum result for each patient.

Surgical correction of the nose - rhinoplasty - provides many patients with the desired aesthetic improvement provided this is performed accurately by a well trained and experienced surgeon. Modern rhinoplasty techniques and anaesthesia carry very low risks with short recovery time and low revision rates.

However, for many other patients who would like to improve their nose, the thought of undergoing a surgical procedure is daunting. Patients who have previously undergone a surgical rhinoplasty are also wary about a further procedure despite a strong desire to correct a deformity following rhinoplasty. These patients remain uncomfortable because of the associated general anaesthetic, risks of surgery and downtime. But until quite recently, these patients had no other option available in order to improve their nose or correct deformities.

The recent improvements in safe and effective injectable products/dermal fillers have made it possible to reshape the nose using a non-surgical technique. The non-surgical procedure can reshape the nose, correct deformities following an injury or previous surgery using dermal fillers such as Evolence or Restylane.

Evolence is a porcine collagen product which provides excellent structural support for the nose and is commonly the first choice in nose shaping. Restylane is the gold standard hyaluronic acid, using the NASHA technology, providing a very safe product which can be used to smooth an irregular nasal bridge or correct small depressions in the nose.

The advantages of the non-surgical rhinoplasty for patients are a safe, local anaesthetic procedure carried out in the clinic, which has minimal downtime and can achieve a high degree of refinement and accuracy in correcting deformities of the nose.

Non-surgical nose shaping does require the same understanding of the anatomy and aesthetics of the nose as required for a surgical procedure, in order to achieve a natural aesthetically pleasing result. The selection of a safe effective dermal filler is also important in achieving a reliable, accurate and long-lasting result and avoidance of complications.

Most frequently, patients request the bridge of the nose straightened, either a bump smoothed out or a mild deviation corrected using the non-surgical procedure. The tip of the nose can also be improved by refining the shape or increasing the projection. Imperfections or irregularities following an injury or previous rhinoplasty can also be effectively treated using the non-surgical technique.

Several patients will opt for a non-surgical procedure to look their best for a significant occasion or simply to use this procedure as a trial before deciding on a surgical rhinoplasty. Unfortunately, some patients believe that their nose can be made smaller without surgery and this concept is clearly false, as a large nose can only be reduced surgically.

Non-surgical rhinoplasty does enable more patients the option to improve the shape of their nose without the need to resort to surgery.
CS&AM