Smooth out nose imperfections with a liquid rhinoplasty
Two types of liquid rhinoplasty patients
I have gotten quite a few requests for liquid rhinoplasty lately. Liquid rhinoplasty is for minor details on the nose. I get both:
patients who actually had a surgical rhinoplasty previously but were just slightly unhappy with the result and they want a little bit of filler to camouflage a defect
patients who actually have a very minor issue with the aesthetic of their nose and would like that corrected.
Why Hyaluronic acid for liquid rhinoplasty?
Liquid rhinoplasty is an off-label use of hyaluronic acid filler that is placed on the nose. This is not about functional naval airway issues. This is purely an aesthetic issue that I have to remind patients about.
I only use hyaluronic acid filler for liquid rhinoplasty or anywhere on the face because it is reversible.
If for any reason the patient's not happy with it, you can use hyaluronidase, an enzyme that will counteract the hyaluronic acid filler and make it disappear.
You don't need a lot of filler for a liquid rhinoplasty - nobody who I’ve worked on needs more than one syringe.
Visual appearances where nose filler is applicable
There are lines called the dorsal nasal lines. If you imagine a line right along from your eyebrows down the nose and towards the nasal tip, that line should be clean and unbroken.
Sometimes right on the junction of the nasal bones on the upper part of the nose and then the cartilaginous nose. Now, there's a break in that line and patients would like to get that filled in. That's one application of a filler for a liquid rhinoplasty.
Another indication is we can camouflage a dorsal hump in the nose. If we look at the patient's side view or the profile view, and if there is a prominent hump, we can actually put filler in what’s called the radix, which is that curved divot at the top of the nose right in between the eyes, and we can actually add filler there make a bump along the nose look less prominent.
What to consider with liquid rhinoplasty
One thing to keep in mind is we can't take away tissue, we can only add. That is why choosing the right injection point and how much is so critical.
The filler lasts about nine months to one year, depending on what you use - so this is a temporary filler.
Situations to consider a traditional rhinoplasty
I've had a patient call in and say, actually “I don't like the droopiness of my nose.” That's something that you need a traditional surgical rhinoplasty for, to fix the rotation of the nasal tip.
Some patients may not like the width of their nose, it’s too wide.
If the dorsal hump is too large, again we can mask it but only so much.
We try to educate the patient a little bit over the phone and say let them know whether they're an appropriate candidate or not before seeing them for a liquid rhinoplasty.
Risks of a liquid rhinoplasty
In general, the safe area for injections is closer to the midline of the nose.
There are two arteries on the face, called the angular artery, which come up by the creases in the nasal lab folds and then extends up to your nose. We really need to avoid that because the biggest risk is loss of the skin called skin necrosis.
If filler was injected into a blood vessel, that blood vessel will clot as it’s filled with filler, and there's would be no blood that can get to the tissue.
That would be very devastating to the patient.
That is a risk of any filler, liquid rhinoplasty or not in the face, so it's important to go to an experienced professional who knows the anatomy really well and knows what they're doing.
What to expect in the appointment for liquid rhinoplasty?
I see patients ahead of time if there are any kind of concerns and talk them through the process. Most liquid rhinoplasty patients have thought about their nose for a long time and are typically ready when they give me a call and I set a 45-minute appointment with me.
This type of patient usually sets a higher bar for me as a doctor, so it's really important for me to take time and listen. I don't look at a patient and say, “this is what you need.” I may have my opinion but I keep my mouth shut and ask the patient, “what is it about your nose that you don't like?” With a mirror, they'll talk and point to their nose and if I agree with their assessment and I think I can fix it, that is an appropriate candidate to kind of proceed with.
Patients that do like the results of a liquid rhinoplasty do become repeat patients and we can schedule them to come back in a year and assess their nose again then, whether we need to inject more or wait a few more months to continue.
Sometimes I actually turn away patients who will talk about a defect that I actually don't think is a defect. In some cases, the defect may be perceived but then I have to assess a patient for anything like body dysmorphic disorder, who is a person that is not going to be happy no matter what you do.
So that's a patient that I know I'll be very frank about, said, “I don't think I can actually help you” and then we walked away.
Conclusion
If you are interested in getting a liquid rhinoplasty in Columbus Ohio, call our office or fill out the contact form to get an appointment. It’s typically a 1-appointment procedure for both asking questions to Dr. Okada and getting the filler injected. We’ll schedule you to visit our office in Dublin and you can make your decision during your consultation.