When it comes to nonsurgical rhinoplasty, the only filler materials that should be used are hyaluronic acid fillers. Hyaluronic acid fillers are the only type of fillers that are reversible, so in the event of any complication they can be dissolved and reversed before creating permanent injury. The landscape of nonsurgical rhinoplasty and liquid nose job has been made murky by some misguided nurses and doctors, and even rarely by some surgeons, who have promoted injecting permanent and semi-permanent materials in the nose. Materials like acrylic and silicone do not belong in a delicate structure like the nose, yet some have insisted on injecting patients with Artefill, Bellafill and Silikon-1000.
What’s the issue with permanent and semi-permanent injections for nonsurgical nose job? The first relates to the lack of biocompatibility of materials like Bellafill and Silikon 1000 with the soft tissue and skin of the nose. They exist inside the nose as foreign material that will never incorporate into the tissue of the nose, but are hardly inert. At best they will remain as discrete microdroplets within the subcutaneous fat, while more commonly they will cause inflammation with subsequent scarring and fibrosis over time. At worst they will form granulomas and nodular scarring, creating contour irregularities throughout the subcutaneous layer but sometimes extending to the skin surface. To make matters worse, even though Bellafill and SIlikon 1000 can easily be injected in a matter of minutes, it takes extremely meticulous and tedious surgical dissection to excise from the nose.
The second issue relates to the permanence of acrylic and silicone injections in the nose. As a material occupying volume, initially the contours created by Bellafill and Silikon 1000 may actually be quite nice. This improvement is of course short-lived, as the soft tissue of the nose does not remain static but rather is a dynamic, viable part of your body that is constantly replenishing cells and changing in shape and form. The Bellafill and Silikon 1000 then have no chance at maintaining the same position within the nose, and subsequently will never be able to preserve the same shape as when initially injected.
Perhaps the most problematic issue with permanent and semi-permanent nonsurgical rhinoplasty relates to the most catastrophic potential complication with liquid nose job: vascular compromise. Vascular compromise results from either an injection into the vessel, or from compression of the vessel by an injection immediately next to the vessel. This leads to blanching of the skin initially, later with darkening and eventually necrosis and sloughing of the skin. Sound scary? It should, because it is. Should this happen with hyaluronic acid filler, the solution is straightforward. Dissolve the offending filler and restore blood-flow to the nose. What happens in the case of a semi-permanent or permanent filler? SOL.
As a patient the internet, social media and Youtube can be tremendous resources for obtaining information and education regarding virtually any topic. It can also be a double-edged sword as the amount of misinformation matches the reputable sources. When it comes to nonsurgical rhinoplasty, I hope you heed this surgical rhinoplasty specialist’s advice to seek out only rhinoplasty surgeons experienced in nonsurgical rhinoplasty to perform your liquid nose job with hyaluronic acid fillers only.
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