Injectable Fillers to Correct Nasal Imperfections

Know The RisksAfter Extreme Weightloss

Rhinoplasty is considered by some to be the most complex of the cosmetic procedures. Many plastic surgeons do not perform surgical rhinoplasty; however, of those who do, even fewer regularly perform non-surgical rhinoplasty. Cleveland, Ohio Dr. Goldman was featured using this technique on Fox 8 television news (see our Videos section).

Injectable fillers for rhinoplasty

Nonsurgical rhinoplasty is really a permutation, or advancement of the use of injectable fillers to treat facial wrinkles. Instead of using the fillers to reduce wrinkles, they are being used to add volume, or fill, specific areas of the nose.

The majority of these fillers are long acting but not permanent. (Permanent fillers should not be used in the nose; their long term safety has not been established at this site.) When injected with finesse and precision, the fillers can camouflage nasal defects and irregularities, mimicking surgical rhinoplasty. The primary advantage of the nonsurgical rhinoplasty technique in Cleveland, Ohio is the lack of significant down-time, which is an advantage of the injectable fillers in general. Two critical differences between non-surgical rhinoplasty and conventional rhinoplasty are:

  1. the filler effect is temporary, typically lasting 6 – 12 months; and
  2. injections cannot make the nose look smaller, since no tissue is removed.

The goals of non surgical rhinoplasty.

  1. camouflage of a bump on the bridge of the nose (a “dorsal hump”);
  2. elevation and refinement of the tip of the nose; and
  3. reduction or elimination of asymmetries in the bridge of the nose.

Since these are often the goals of surgical rhinoplasty, some patients may be candidates for the non-surgical approach also.

The goals of non surgical rhinoplasty.

To use an injectable filler to mimic a surgical rhinoplasty requires intimate familiarity, and extensive experience, with both injectable fillers and rhinoplasty, which is why relative few Cleveland Ohio nose surgeons perform this technique. Dr. Goldman was the first of nose surgeons in Cleveland, OH to feature this new technique, and he probably has more experience with Ohio non-surgical rhinoplasty than any other physician in the region.

How does this non surgical rhinoplasty work?

Fillers add volume where ever they are injected. Restylane™, Juvederm™, Perlane™ are all made of hyaluronic acid, which is a chemical found in human skin and joint fluids, where it makes up a part of the extracellular fluid called ground substance. Hyaluronic acid attracts and binds water, plumping up the skin to fill wrinkles and creases in the face or to recontour the nose. Radiesse™ is a chemical called hydroxyapetite that is a building block of bone tissue. It tends to be more firm than hyaluronic acid and lasts longer in most patients, so Dr. Goldman uses Radiesse™ for most of his Cleveland nonsurgical rhinoplasty patients.

When the filler is injected just above a bump on the bridge of the nose, it will make the bump look smaller or even eliminate it in some patients. Filler injected properly into the tip will make it look elevated and refined. The tip may look smaller and less bulbous even though filler has been added to it. Depressions or asymmetric areas can also be filled and smoothed.

Is it safe?

The safety and efficacy of filler injection in the nose has now been well established through the experience of Dr. Goldman and other plastic surgeons nationally. There has been one case report documenting infection of filler material that was injected too close to the internal surfaces (the mucosa) of the nose. There have been no other documented adverse events. Furthermore, fillers like Restylane™ and Radiesse™ have been used for several years in the United States and Europe, with no allergic reactions or similar events. The main risks include asymmetry, lumpiness or nodularity, and bruising, which can last for up to 3 weeks, like any bruise. Cleveland Ohio nose surgeons including Dr. Goldman, prefer to be conservative at the first injection in order to minimize these risks. More filler can be added at a second setting to achieve an even more dramatic result, once the patient is comfortable with the technique and its effects.

What is the downtime?

Down-time is similar to that of injectable fillers used elsewhere on the face. Most patients have mild swelling and skin discoloration for 2-3 days. Most men do not find the need to cover this. Most women use their regular makeup. Almost all patients return to work the next day. A small percentage of patients (perhaps 10% in our practice) will have more significant bruising that requires (if patient wants to conceal the bruise) cover-up makeup. Such bruises can take 2-3 weeks to resolve, like a bruise from any cause.

Why choose Cleveland Ohio nose surgeon, Dr. Goldman?

Dr. Goldman is Board Certified in Plastic Surgery and Otolaryngology/Head and Neck Surgery (ear, nose, and throat surgery), has a special interest and extensive experience with rhinoplasty. In addition, he has extensive experience with injectable fillers, and was one of the first Cleveland Ohio nose surgeons to utilize this technique for the nose. Given his experience with surgical and nonsurgical rhinoplasty, he can help determine which procedure is best for you.

If you have any questions about nonsurgical rhinoplasty, please feel free to email Dr. Goldman at