Hello Doc Bermant, I got a non surgical nose job to try out the results before going through with the surgical option. From a couple of traumas nose is structurally weak and deficient in the lower half. Volume was added along the right sidewall and down towards the tip and a curvilinear depression on left side of tip was filled out. The injections were done from inside of nose. Wanted to know would the needle trauma to the inner side of a weakened nose have a negative impact on the nasal components/tissues and is there a risk of permanent deformity from such a maneuver. Thank you
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.
Welcome to our forum.
A "Non Surgical Nose Job?" Now that sounds like a possible marketing phrase, not something I ever tried or would consider doing. But to evaluate such claims I would use the same criteria from our resource How to Pick a Plastic Surgeon
. I have been working on the subsections, and hope to get to the How to Choose Your Rhinoplasty Surgeon some day. They would be based on Standard Rhinoplasty Pictures
or possibly more issues specific to nasal surgery like discussed on this post Re: Collapsed nose due to Cocaine use
There are valid non surgical options for nasal problems like acne scars, where collagen or dermal fillers some like as a treatment option. I did not like the permanency issues to offer that for my own patients.
One important issue for evaluating a non surgical option, can that doctor offer surgery? Do they have hospital privileges in that operation? What Board Certifications do they have? Here is something I used to check doctors I was seeing complications from the American Board of Medical Specialists:http://www.certificationmatters.org/is-your-doctor-board-certified.aspx
I did offer non surgical options such as Non Surgical Body Shaping Garments
which were an immense asset for my patients who were trying to stabilize their problem or wait until they could afford surgery, or the right time of year. The difference, is that option had careful documentation of before after pictures and I could offer surgery and demonstrated the options each way with critical documentation.
But back to a "Nose Job." When I was still in practice evaluating unhappy patients after surgery done elsewhere, the starting point is
What was the original problem?
What sort of trauma happened before? Some Nasal Fractures
can leave parts of the nose stronger with the healing process, other problems can weaken, just depending also on many factors.
What was done?
What was the individual unhappy about?
What was my exam of the tissues like?
Some of the unhappy patients I saw had silicone nasal injections, silicone implants, other implants like gortex, acellular matrices of various types, cadaver dermis, and a whole slew of different substances.
The basic problem I saw that was not well documented by most proponents was the airway. To push out, any material put between the skin and the cartilage must push back in. This is usually not a factor when referring to the dorsum and support by the underlying septum framework. However, I saw complications when even that support was buckled when trying to convert a flat nose into a projecting one like an Oriental to Caucasian modification. But for the critical internal valve of the nose, it takes so little to destroy the airway. The tip support is somewhere between. I have seen even surgical attempts at projection disrupt the support system. Careful before and after pictures and measurements were the best I was able to come up with before my practice evolved away from Rhinoplasty sculpture.
Now what happens if a supporting system is weakened from some injury, event, surgery, or what ever? Too many factors to be able to prove one way or another. We all get swelling from trauma. That distorts the nose. But minimizing the amount of the swelling and length of time probably lowers the probability if the effect being permanent. What about longer effects of a material that is mostly gone after x months? Again, who is able to document the changes? How critically are they showing proof that the nose returns to the prior state? Again, I did not see enough proof to offer it.
I did offer structural changes using cartilage grafts and suture to get living tissue to continue the shape. I did like what I saw others showing me to offer that type of Rhinoplasty. But for permanency, my patients were cautioned about the fickle nature of the nose and its cartilage framework. Use this site's search engine and you will see that phrase all over the Encyclopedia and forums. That is the nature of the material.
For my patients I preferred using my computer drawings during my Rhinoplasty Consultations
to discuss the range of what surgery might offer. But the beauty of about the thinking mind, is that whatever I was doing, I was looking for something better. I have yet to see a "non surgical nose job" that I was willing to offer. But time are a changing and perhaps something will become available. I like the idea of structural shape Reconstructive Ear Otoplasty Forum - Building Ears With 3D Printing Progress
. Something that can tie into real current support or provide new support on its own But these are structural frameworks that are hopefully going to be built out of our own body's cartilage, a living support system, that my guess will be a surgical sculpture.
Back to your problem. Why not post before pictures and after pictures?
Hope this helps,
Michael Bermant, MDLearn More About Rhinoplasty, Septoplasty, and Sculpture