5 Things You Should Know About Liquid Rhinoplasty

The invasiveness and permanency of a surgical procedure are often big considerations for those interested in going under the knife – you’ll likely have some downtime and there’s no going back. The market is ripe with non-surgical treatment options (we recently broke down some of the most exciting advancements), but few cosmetic surgeries have a non-surgical counterpart that can offer similar results, sans operation. One of those unicorn pairings, however, is the ever-popular surgical rhinoplasty and its less invasive sister, the so-called liquid rhinoplasty.

You may already know that both procedures can enhance the shape of the nose and address aesthetic concerns, but, as it turns out, their commonalities don’t stop there. In fact, a liquid rhinoplasty “is a great alternative to surgical rhinoplasty for those interested in improving the side view of their nose,” says Usha Rajagopal, MD, a board certified plastic and reconstructive surgeon and founder of San Francisco Plastic Surgery & Laser Center. As she explains, it can even “improve some function concerns, however, it’s mostly for those who want to contour the profile view.” This is especially true, she says, “if they have a hump or a nasal bump.”

Since you’ve undoubtedly seen transformative before and afters of liquid rhinoplasty on social media, it’s time to get to the bottom of what the procedure can and cannot do. Read on for the top five things you should know about the non-surgical nose enhancement solution.

1. It’s a Quick – But Temporary – Fix

The most obvious differences between a surgical rhinoplasty and a liquid rhinoplasty: recovery and results. “This is not a permanent procedure and not a substitute for a surgical rhinoplasty,” Dr. Rajagopal says. But, unlike a traditional rhinoplasty that requires anesthesia to perform, a couple months to recover, and a year or more for full healing, it’s non-surgical counterpart “is only 10 minutes long and requires no downtime with minimal discomfort,” she notes.

A before (left) and after (right) look at one of Dr. Rajagopal's liquid rhinoplasty patients.

In her practice, Dr. Rajagopal uses a Restylane® product because “it’s hyaluronic acid and can give a nice lift to the area of treatment.” Like HA filler for other areas of the face, results last up to a year, at which point they need to be touched up. Should you experience buyer’s remorse, the filler is dissolvable via hyaluronidase injections.

2. There Are an Array of Benefits

Strategically placed hyaluronic acid-based filler can shape and contour the nose. “The ideal candidate is a patient who only has one or two issues with their nose that they are unhappy with,” Dr. Rajagopal shares. For example, “if the tip plunges or dips affecting the smile,” they may be a candidate, she says. Others who may benefit from filler are those with petite sniffers. “A patient with a smaller or shorter nose can benefit, as the product can give them volume and elevating the nasal dorsum gives a nice aesthetic result,” she explains.

It can also work wonders for nose bump concerns. “When I do a liquid rhinoplasty, I’m actually adding product to camouflage a hump,” she explains. “I will go on either side of the bump to reduce its appearance, and, oftentimes, I will add to the tip of the nose to give it a little lift and give it a nice, smooth appearance.”

A before (left) and after (right) look at one of Dr. Rajagopal's liquid rhinoplasty patients.

While it’s not the same as combining a facelift and skin resurfacing, blepharoplasty and brow lift, or rhinoplasty and chin implant, pairing a surgical and non-surgical rhinoplasty may be beneficial for those who feel prior surgery hasn’t achieved their desired look or for those who have experienced specific complications post-op – which leads us to…

3. It Can Address Certain Functional Concerns

Those who have undergone a surgical rhinoplasty may be aware of the potential complications, adverse effects, or suboptimal results. A liquid rhinoplasty may come into play for those not interested in a traditional revision rhinoplasty. “It can help some functional concerns, especially if patients have had a rhinoplasty done and have had a middle vault collapse or have the central part of the nose slightly depressed,” Dr. Rajagopal says. “This happens when some of the cartilage has been over-resected and the internal valve or the internal part of the nose hasn’t been opened up again.”

Candidates who experience breathing problems due to the projection of the nasal tip may find relief as well. “For those who have a droopy tip, lifting it up can improve breathing function,” she shares. “Over-resected tips or nostrils can be improved.”

4. There Are Risks

We always emphasize the importance of finding a skilled injector. While no HA fillers are indicated for use in the nose area, liquid rhinoplasty can be safe and effective in the hands of a pro. Experience is particularly important in this case, however, because the nose area is at an increased risk of vascular occlusion, which is one of the most serious filler complications. “The nose has a lot of vascular structures and those connect directly to the eye or the brain,” Dr. Rajagopal explains. If filler is accidentally injected near or into a blood vessel, it can become occluded due to the pressure. Too much pressure can limit blood flow, leading to skin necrosis (read: death) and, in the most severe cases, blindness.

Promptly dissolving the filler with hyaluronidase can remedy the situation without damage, but the provider must know what to look for (including how to delineate between normal post-injection bruising and the discoloration caused by vascular occlusion). “That’s why it’s important to find an expert who knows how to handle those complications if they do occur,” she emphasizes.

5. Not Everyone Is a Candidate

While there is a lot a liquid rhinoplasty can do, it is not for everyone. “Someone who has multiple concerns they are unhappy with and want to change may not be a good candidate,” Dr. Rajagopal says. Filler can augment the nose, but it can’t reduce its size. “Those who have a big nose but want a significantly smaller shape won’t be able to achieve it,” she explains. “[Similarly], those with a wide nose – whether it’s a wide bridge or wide nostrils – may not be a good candidate.”

For some, liquid rhinoplasty can serve as an alternative to a surgical revision, but this is not a hard and fast rule. “Someone who has had a rhinoplasty done where a cartilage or silicone implant has been used and there is no space to put the product in may not be a fit for a liquid rhinoplasty,” she shares. She makes these decisions on a “case-by-case basis.”

A before (left) and after (right) look at one of Dr. Rajagopal's liquid rhinoplasty patients.

The Takeaway

A liquid rhinoplasty may be a ‘lunchtime’ procedure, but there’s more to it than meets the eye. Like all injections, the provider should be thoroughly vetted and the patient should go in with realistic expectations. While it can improve nose shape and contour, not every aesthetic concern can be addressed sans surgery. A consultation with a board certified plastic surgeon will help determine if you are an ideal candidate for liquid rhinoplasty.