The Ideal Nose In 5 Minutes Without Surgery: A Doctor Tells All

Are you self-conscious of your nose that you wish it could be a little taller and more defined or have a hump on your nose that you wish to flatten? Have you ever considered improving the shape of your nose but do not want to go through surgery? You are not alone.

As Asians, we tend to have a flatter nose bridge and a wider (bulbous) nose tip compared to our Caucasian counterparts. This causes the middle face to lack definition and ideal proportion. Therefore, nose and chin enhancements in Asia are commonly sought-after aesthetic treatments for better mid-face projection to establish facial harmony.

Non-surgical rhinoplasty is one of my favourite procedures to perform as patient satisfaction is immediate with low to no downtime.

In this article, I will explain the difference between nose filler and threadlift and how I maximise the benefits of both procedures while overcoming their disadvantages using a combination approach for my patients.

 

Nose Filler

In nose augmentation, fillers are used for nose bridge and tip projections and flattening of humps (Figure 1 & 2) through precise volumisation.

 

When using filler for nose augmentation, the most important factor that will determine a good projection and satisfactory result is the rheology¹ of the filler. Both rheological properties of high G prime and cohesivity are critical for the best possible nose projection. The other important consideration is the longevity of the filler.

In my practice, I use a wide array of fillers as each of them has different unique properties to cater to my patients’ individual needs.

 

Nose Threadlift

Most nose threads contain barbs or cogs that lift the soft tissue when inserted in the correct soft tissue plane. Threads are inserted through a single-entry point made via a needle at the tip of the nose in between the nostrils, for both nose bridge and tip definition and contouring (Figure 3). Threads also have a collagen stimulating effect and therefore can lead to further lifting effects over time.

In nose augmentation, it is preferable to use threads that are thicker and have sufficient barbs or cogs so as to give the most significant result with least number of threads needed. Lesser threads inserted and more barbs or cogs per thread to provide proper anchoring of soft tissue will reduce the chance of thread extrusion and migration that can lead to infection.

In addition to the type of nose thread used, the injector’s expertise is also key. Threads have to be placed in the correct soft tissue plane in order to get significant and natural looking results without the problems of thread migration and extrusion. Further, any slight deviation in the angle that does not follow the direction of the nose bridge during thread insertion can result in a slanted nose.

 

In summary, fillers are better for nose projection and correction of any humps through volumisation. Although low, the risks of vascular compromise causing blindness and skin necrosis are significant adverse outcomes that can be avoided in experienced hands. In addition, techniques such as using a blunt cannula instead of a sharp needle when performing nose filler helps to prevent inadvertent intravascular injection.² With a cannula the blood vessels are pushed out of the way because the tip of the cannula is blunt and harder for it to penetrate into the blood vessels. Injecting small amounts of filler slowly also helps to reduce vascular risks.³

 

 

Other Tips and Tricks for Refinement of The Nose

In the field of medical aesthetics, botulinum toxin is used to relax facial muscles. Specifically for the nose, it can relax the nasalis muscle that causes a wide nose tip and nasal flare.

Fillers placed in the canine fossa to improve the nasolabial fold (smile lines) can also cause a reduction in the nose tip by pushing it inwards. However, this procedure requires technical expertise to achieve the intended result in a safe manner.

 

Outcome

The intended result from non-surgical nose augmentation should be for patients to see an immediate improvement in projection and definition of their nose while minimising discomfort and downtime.

Patients often feedback that they can see their nose bridge better and that they do not have to use make up to contour their nose anymore. At the same time, it is a subtle enough difference that provides better facial harmony without a drastic change in shape.

 

Conclusion

In summary, non-surgical rhinoplasty using fillers and threads require both technical expertise and a keen aesthetic eye to consistently produce ideal results in a safe manner. An examination by and discussion with your doctor prior to embarking on this procedure allows for a shared decision of the treatment approach to obtain your desired results. Do not be afraid to ask questions and enquire for before and after pictures prior to embarking on any aesthetic procedure.

A successful enhancement of the nose is one that creates a natural 3-dimensional improvement that compliments the entire facial aesthetic profile. Family and friends will comment that you look prettier or more handsome but are unable to pinpoint exactly what has been done. That, to me and my patients, is the biggest compliment.

 

References

1. Pierre S, Liew S, Bernardin Basics of dermal filler rheology. Dermatol Surg. 2015 Apr;41 Suppl 1:S120-6.
2. Fulton J, Caperton C, Weinkle S, Dewandre L. Filler injections with the blunt-tip microcannula. J Drugs Dermatol. 2012;11:1098–103.
3. Sito G, Manzoni V, Sommariva R. Vascular Complications after Facial Filler Injection: A Literature Review and Meta-analysis. J Clin Aesthet Dermatol. 2019;12(6):E65–E72.

 

Written by Dr. David Deng,

MBBS, MRCS

 

8 Medical Aesthetic Clinic

Disclaimer: The material contained in this is for informational purposes only and do not constitute medical advice. The content is not intended to be a substitute for doctor’s advice, diagnosis, or treatment.