Surgical rhinoplasty is the one of the most common cosmetic procedures in Asians. But there are limitations, such as down time, high cost, and a steep learning curve. Most complications are implant related. A safer and less invasive procedure is rhinoplasty using fillers. Good knowledge of the nasal anatomy is essential for rhinoplasty using fillers. Knowledge of nerves, blood supply, and injection plane allows avoiding complications. There are several planes in the nose. The deep fatty layer is recommended for injection, because it is wide and loose and there are less important neurovascular structures. Botulinum toxin also can be used for noninvasive rhinoplasty.
Key points
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The nose is the area in which most people make enquiries for procedures – especially filler augmentation, and the most important thing is to make the shape of nose that fits each person’s image.
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The nonsurgical nose augmentation procedure with filler is classified in 2 categories: the dorsum of the nose and the tip of the nose.
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After comparing and analyzing the ideal nose shape and the patient’s nose shape, decide which part is to be raised and by how much.
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The most common report of dissatisfaction of nonsurgical nose augmentation with filler is asymmetry. To prevent this, the tip of the needle should be located in the center line during the procedure.
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Filler must be injected to the deep fatty layer (between the perichondrium or periosteum and muscle layer) where important blood vessels are not located. That helps avoid severe side effects, such as skin necrosis.
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