Who Nose?

By Christianna Ablahad

(Published in the April 2010 issue)

If your schnoz has a hideous hump or a barely discernable bridge, or you’ve already gone under the knife only to come out with a pinched beak (think the entire Michael Jackson family or Lil’ Kim) or an asymmetric one (think Teri Hatcher or Tori Spelling), you may be a candidate for a non-surgical nose job.

Rhinoplasty has long been the only solution for imperfect noses, but with the advent of hyaluronic acid-based facial fillers such as Juvederm, Restalyne and Perlane, inventive doctors are helping certain patients improve their looks and confidence without ever picking up a scalpel.

Though using these temporary fillers for the nose is technically considered off-label-meaning the FDA has approved filler use for nasolabial folds (the laugh lines) only-Dr. John Hilinski, a San Diego facial plastic surgeon, is injecting fillers into other areas “very effectively and safely,” he says. Hilinski notes that the fillers can last longer in the nose than elsewhere on the face, because the nose doesn’t move nearly as much.

Long story short, if your nose smells, that’s good news. If it just plain stinks, filler up!

Hump Day: If you have a bothersome hump, Dr. Roy David of the La Jolla Center for Facial Plastic Surgery, says, “A nonsurgical nose job can camouflage it by adding filler above and below, almost making it look like the hump is gone.” Even though injections technically make the nose bigger, the fillers soften the appearance of the hump, creating an optical illusion that the nose is actually smaller.

The Fix is In: If you’re the victim of a bad nose job, fillers may help. Various post-surgical deformities-from the pinched tip with unnaturally deep too-grooves on the side of the nose to a “saddle deformity,” which Dr. Hilinski describes as the cookie-cutter nose with a ski-slope profile-can be corrected to make a nose look more natural and less surgically altered.

Size It Up: Hilinski says, “some patients like to ‘try on’ a nose before getting surgery.” By injecting facial fillers, he can show patients what their noses would look like after surgery. If they don’t like what they see, a shot of hyaluronidase enzyme usually dissipates the filler within a few hours.

Nose No-Nos: If your nose is too wide, adding to it with fillers might make you look like Elmo. If your skin is too thin, it might not camouflage the filler well enough.

Costs: depending on which products your doctor uses, the average cost for a non-surgical nose job is about $500, versus about $6,000 for a surgical correction
Time: usually just one 15-minute office visit
Downtime: none, meaning no time off work and no weeks of bruising or swelling
Visible results: immediate, can last six to nine months
Pros: avoidance of surgery and its possible complications; no downtime; predictable results
Cons: lack of permanence means maintenance costs add up over time; possible (but rare) contour abnormalities