Will a filler rhinoplasty work for my nose?

What is a filler rhinoplasty? Will a filler rhinoplasty work for my nose?

If you watch any form of social media lately, you’ll see numerous TikTok videos or Instagram reels of providers performing “liquid rhinoplasties.” These procedures are on the rise, and many of my patients are asking me if it’s right for them.

The short answer is that, for safety reasons, I generally do not recommend liquid rhinoplasty.  Although certainly less invasive than a surgical rhinoplasty, filler injections come with an uncommon but major risk called injection related vascular compromise or IRVC.   Injecting the filler material into or around a blood vessel can lead to diminished blood flow to the tissue.  In rare instances, the filler can move through the small vessels of the face back toward the eye and can result in blindness.  In one recent study from 2021 with almost 2500 patients injected by an experienced rhinoplasty specialist, the incidence of a tissue compromise following nasal filler injection was 1 in 500.  Thankfully there were no reported cases of vision loss in this group.  The other more common risks of filler injections are much more tolerable, including bruising and swelling.  For those who do not like the cosmetic appearance after liquid rhinoplasty, a dissolving agent called hyaluronidase can be used to rapidly dissolve the product.

Despite the risks mentioned above, there are some circumstances where a liquid rhinoplasty is reasonable and even advisable.  The midline of the nose is generally a low risk area for injection-related vascular compromise, so this technique can be particularly useful if your primary concern is a small hump visible on profile view.  A precisely placed amount of filler above or below your hump can lead to a straighter appearing profile without putting your blood vessels at as much risk for compromise.  Another sensible case for “liquid rhinoplasty” is when there are minor visible asymmetries after a previous surgical rhinoplasty.  In these cases, I will place a very small amount of filler using a blunt tipped needle (called a cannula) in order to minimize the chances of injecting directly into a blood vessel as much as possible.

The obvious benefit of liquid rhinoplasty is that it can be performed in a clinic setting, has very little downtime, and is generally significantly less expensive than a surgical rhinoplasty.  I typically use Juvaderm Volbella © or Juvaderm Ultra © because they are relatively thin and pliable fillers and blend very well without lumps.   A filler rhinoplasty typically costs between $1200 and $1800 dollars compared to the $6,000 to $10,000 price tag for a surgical rhinoplasty.  Although these filler materials generally absorb over time in other more mobile areas of the face, my experience has been that most filler rhinoplasty patients are able to maintain their results after 2 or 3 treatments, spaced apart by a year or so.

If you’d like to know more about filler rhinoplasty and whether it could be right for you, please contact my office for an appointment.


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