Dr. Nogan on Liquid Rhinoplasty (Nose Filler)

Is injecting filler into the nose safe? Is it worth it? How does it compare to surgical rhinoplasty? These are questions I seem to be getting asked more and more as Liquid Rhinoplasty becomes more popular. In this post, I’ll try to tackle these questions in plain language and use a recent patient as an example of how both Liquid and Surgical Rhinoplasty can be effective.

First, let’s start with anatomy. The blood supply to the nose is a complex network of interconnected vessels. This makes both cosmetic and reconstructive surgery of the nose easier and safer, but it makes injecting synthetic fillers into the nose harder and more risky. The goals of Liquid Rhinoplasty are often to camouflage a bump and/or raise the tip of the nose, and this network of blood vessels MUST be avoided. If an injection needle were to pierce a blood vessel and synthetic filler were to enter, catastrophic damage could be done to the skin and even one’s vision.

Thankfully, these complications are rare in the hands of expert injectors. Liquid Rhinoplasty can be a gratifying procedure for someone who isn’t quite ready to consider surgery but would still like to make a change to the appearance of the nose. Filler injections can be costly and are always temporary, but still may be worth it as a “no down time” option in some circumstances. I perform these injections occasionally, but only after a serious discussion about risks, benefits and alternative options.

Now all that being said, as a surgeon I have a strong preference toward surgical rhinoplasty. During rhinoplasty procedures I have better exposure and visualization, better control of technique and outcome, and better ability to reduce risk and irreversible complications. While these are all things that should put a patient at ease, there are obviously other factors. General anesthesia is required. There is a short period of down time after the procedure. Cost can be a concern. Most importantly, there must be a trusting relationship between the patient and the surgeon often built through several consultations discussing goals, expectations and limitations.

The patient photos seen here show a patient’s journey from liquid rhinoplasty to surgical rhinoplasty. He was initially bothered by a bump on profile view and a drooping tip. He was so pleased with the appearance after several synthetic filler injections by another physician that he decided to look into a more permanent surgical solution. After several consultations with me, we decided to dissolve the filler present above the bump and proceed with surgical rhinoplasty. The intra-operative photos (on our instagram page) show some filler material still present in the tip—this was easily suctioned and removed. The next surgical photo shows an example of one type of cartilage graft we use to permanently improve a patient’s nasal profile. The final photo shows the nose with the graft in place and the skin closed at the end of the procedure. The patient is recovering well, and he looks and feels fantastic.

Everything we do at Columbus Facial Plastics comes down to one thing. Trust.

Honestly educating our patients. Building real relationships. Delivering our very best. Every time, every patient.

To Your Health,
Steve Nogan