Rhinoplasty – Surgical vs. Nonsurgical

Let’s face it, surgery always some degree of pain, swelling, restriction of activities, and delay before seeing the final result.  Not to mention the cost, and the anxiety of having to undergo anesthesia.  So nonsurgical alternatives have an understandable appeal.  These alternatives are not the equivalent of surgery, however, and expectations need to be realistic.  Most people by now are familiar with injectable fillers for facial rejuvenation including Juvederm, Radiesse, and Restylane.  But many people don’t realize that in some patients, cosmetic improvements to the nose can be effected with injectables, forgoing the need for surgery.


The injectable filler that I prefer for use in the nose is Radiesse, and like all fillers, it is used to fill.  This may seem obvious, but some people think nonsurgical rhinoplasty is an option in every situation.  The whole idea behind nonsurgical rhinoplasty is to fill in an area that is depressed or indented, either from previous injury or surgery, or just the natural shape of the nose.  This is a fairly limited application – if your nose profile has a big hump, a filler will not accomplish what you want, and you will need surgery to bring it down.


Nonsurgical rhinoplasty can be done in a few minutes with minimal discomfort and recovery.  It is always best to be undercorrected than overcorrected, so you may need to come back in for a touch-up within the first two weeks.  The effect is not permanent, but can last well over a year with Radiesse.


If you are not a candidate for nonsurgical rhinoplasty, then a fairly lengthy discussion of surgical rhinoplasty will be done during your consult.  There are different types of rhinoplasty for different types of noses, and expectations and risks need to be considered.  I have morphing software that helps this process by allowing me to simulate what your nose will look like after surgery.  The photo morphing can also be done for nonsurgical rhinoplasty patients.


Douglas Mackenzie, MD, FACS,

Pacific Plastic Surgery, Santa Barbara, California

Douglas J. Mackenzie, MD

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