Your Questions
Your Questions
Q: Dr. Eppley, I am interested in a non-surgical rhinoplasty. I am a 32 year-old female who does not like her nose. My nose has a dent and a crack in it. It has always been there as long as I can remember but as I get older it seems to be getting worse. I am scared to get a surgical nose job because if I don’t like it I will be stuck with it. I know an injectable rhinoplasty is not permanent but it is less scary to me.
A: A non-surgical rhinoplasty, also called an injectable rhinoplasty, is a quick and fairly simple procedure that can be done in about 15 minutes. The only type of nose problem that is amenable to injection are those that can be ‘cured’ by the addition of volume. These include a deep radix, a nasal hump, indentations, depressions and some minor drooping tips. While almost any of the current injectable fillers can be used, it is safest to use a hyaluronic-based filler (e.g., Restylane, Juvederm) as it has good linear flow properties through a 30 gauge needle. There usually is little to no bruising and minimal swelling afterwards. The duration of the nasal correction will last as long as the type of injectable filler used, most commonly six to nine months.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am interested in a non-surgical rhinoplasty. I really need my nose fixed. I’ve been so depressed about my nose for about 7 years. I’m 20 years old now. I know I can’t afford surgery so I thought hopefully I can afford this. Why stay sorry for myself when I can do something about it, please help ! I have attached a picture so you can see my nose shape problem.
A: Based on your picture, you are not a candidate for a non-surgical rhinoplasty. This very limited nose reshaping technique uses injectable fillers to build up certain parts of the nose. Almost always that is done to build up the area above a hump or bump in the upper nose. What you have is a wide or fat nasal tip due to large lower alar cartilages and how they come together…or don’t come together. Correction of the wide nasal tip requires an open surgical approach with cartilage reduction and reshaping with sutures. That can be tremendously effective in reshaping the tip of the nose but it is a surgical procedure. Just for a tip rhinoplasty procedure done in a one hour procedure under general anesthesia the cost is around the $4,000.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I would like to know if I can have a non-surgical rhinoplasty for temporary basis. At the moment I do not have sufficient funds to afford a rhinoplasty. Will there be dying of the skin or problems with the skin if I do this. Do you think i can have this procedure based on my nasal anatomy. Please let me know thanks.
A: The best type of nose for a non-surgical or injectable rhinoplasty is the patient with a small to moderate-sized dorsal hump. This provides a perfect place to place an injectable material above the hump in the upper nasal bridge or nasion area. By so doing the hump is camouflaged as the dorsal line is straightened from the tip of the nose up to just below the eyebrows. Your nose is the perfect candidate for it as you fulfill this anatomic criteriua. I have attached some imaging which shows what the result would look like. The only question is what type of injectable filler to use of which they are a large number of choices. I would chose one of the longer acting ones like Radiesse or Juvederm XC which should last about a year. This is done in the office under topical anesthesia and takes about 10 mnutes to perform…which is why the procedure has earned the name of injectable rhinoplasty or ‘lunchtime’ rhinoplasty.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, Hello, I am interested in non-surgical rhinoplasty as well as a small amount of Botox. What is the cost per unit of Botox and the approximate cost of non-surgical rhinoplasty for a dorsal hump. Thanks!
A: My assumption is that you are inquiring about 12 to 16 units of Botox for the glabellar area and about .3cc of Radiesse above a dorsal hump. (non-surgical rhinoplasty) You could expect to pay about $200 for the Botox and about $400 for the Radiesse injections. Expect that the Botox will last about four months and the Radiesse to last close to one year after injection.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have a dorsal hump on my nose. I had a consult with another doctor who mentioned using fillers or if electing surgery breaking my nose. I do have breathing problems in my nasal area which we discussed also. But, I am concerned about dramatically breaking my nose. I am African American. I do not want a slender Jackson Family nose. I want to look like myself, just better 🙂
A: While the African-American nose typically has a low and wide nasal bridge, it can still have a dorsal hump. Or in the low nasal bridge a pseudo dorsal hump, a dorsal hump that appears to be there because of a low nasofrontal junction or radix area. There are two approaches to your dorsal hump removal , augmentation or reduction, which has already been discussed with you. Augmentation may be a better approach for you since you already have a breathing problem and you fear too slender of a nose. The only role that fillers would play in my hands for your nose is to determine whether augmentation above the hump produces the desired effect. This is a good simple and reversible test using the non-surgical rhinoplasty concept. If filling above the hump produces a good look, then you can proceed with a rhinoplasty doing dorsal augmentation using either a cartilage graft or an implant. Each has their own advantages and disadvantages which needs to be discussed in detail.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have a question about nose hump removal. I know that rhinoplasty surgery works well for taking down a large bump on the bridge of the nose. But I would like to avoid surgery if possible. May I ask if you`re familiar with nose magic product? Is it worth trying? The company responded quickly to my inquiry, saying that it can help by moving cartilage.
A: I am very familiar with Nose Magic and use a companion device occasionally on my postoperative patients to manage their persistent tip swelling. Do I think it will work to permanently take down a nasal hump…no. Did I think you have anything to lose by using it…no. It has its effect by temporarily squeezing the fluid out of the tissues causing a slight change in shape, just like when you pinch it and hold it for awhile. The problem with a nasal hump is that at least half of it is bone whose shape will not be altered by any form of external pressure. While nothing sells like hope, at least you can prove to yourself one way of the other, of this non-surgical approach to nose reshaping. You will find in the end, however, that only a surgical rhinoplasty will really work.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am a Mexican-American and want to get my nose fixed. My nose is flat in the middle while the tip is wide and droopy. Do you think a non-surgical nose job can lift my nose? I am afraid of surgery since I have never had any and because it would take time to heal.
A: The concept of a non-surgical rhinoplasty is understandably appealing but it is a far overblown treatment method in terms of what it can really achieve. It is the use of injectable fillers to augment or plump out certain areas of the nose. For the right problem, such as an indentation or depression in the nose, it can be very effective. It can also raise up part or all of the dorsal line of the nose or even push out a retracted columella. But it can not create an overall global change in the nose such as what you appear to need by your description. An injectable filler will help fix the ‘flat area in the middle of your nose’ because that is an augmentation issue. But the technique can not make a ‘tip less wide and droopy’ as that is a reduction issue. In trying to lift your nose with a filler you would merely make it more wide and fat with little lifting effect. A non-surgical injectable approach has its best use in correction of some postoperative irregularities after a rhinoplasty and is the most common usage in my plastic surgery practice.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Does Dr. Eppley perform non-surgical rhinoplasty? If so, how many has he done and what does it cost?
A: I have performed non-surgical rhinoplasty, otherwise known as using an injectable rhinoplasty. It is about using an injectable filler most commonly in the upper part of the nose (radix) to treat (hide) a hump. I have done that office procedure numerous times. It is only good to fill the bridge area above a hump to make it smooth. In a few other cases, I have used injectable fillers for small areas of fill-in for dents and asymmetries in other parts of the nose. But you can’t do a complete rhinoplasty or even a partial rhinoplasty in a non-surgical fashion. So the concept of an injectable rhinoplasty is for filling in small defects in the nose. It is also important to realize that these effect are temporary (one year or less) and not permanent.
I would have to see pictures of your nose to determine if this procedure is for you. If so, the usual injectable filler used is Radiesse because it lasts the longest although other fillers can be used. (e.g., Juvederm)The cost of the procedure is based on how much filler is used and what type. It could range anywhere from $350 to $850 depending on those factors.
Another form of injectable rhinoplasty is that using diced cartilage. While it does require a septal graft harvest, the cartilage is diced and injected through small syringes from an incision inside the nose. This injectable rhinoplasty procedure does require an anesthetic to perform and so it is better called a minimally-invasive rhinoplasty.
Dr. Barry Eppley
Indianapolis Indiana
