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Non-Surgical Rhinoplasty Fillers

Which Filler Material Is Best?

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Updated November 10, 2009

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Fillers Commonly Used For Non-Surgical Rhinoplasty

There are many cosmetic injectables available on the market today, each with its own advantages and disadvantages for use in non-surgical rhinoplasty.

Juvederm and other hyaluronic acid-based fillers: These fillers generally produce results that last approximately 6-8 months. They are believed to be very safe, and significant long-term complications are so far unheard of. In addition, if the patient is not happy, the effects can be dissipated much sooner through the injection of an enzyme preparation.

Radiesse and other calcium hydroxyapatite-based fillers: These fillers are not permanent, but can last up to a year. Like hyaluronic-based fillers, they are believed to be very safe, and significant long-term complications are unheard of so far. They are suitable for all but the most cautious patients, as they must “run their course” over the expected time period if the patient is not happy with the results.

Artefill: Artefill is the only currently FDA-approved permanent filler on the market. Artefill is made of polymethylmethacrylate (PMMA) microspheres (tiny beads), a material that has been used for years in surgical implants. Its main advantage and its main disadvantage are one and the same: It’s permanent.Alexander Rivkin, MD, whose medical practice specializes solely in non-invasive cosmetic procedures, with an emphasis on injectables, recommends that anyone considering a non-surgical rhinoplasty try one of the temporary fillers listed above before committing to a permanent filler like Artefill. This not only provides a chance to see if you like the results, but also a chance to test-drive the skill and precision of your doctor in performing the procedure.

Silicone:Thanks to sensational media coverage (i.e., the “Priscilla Presley and Dr. Jiffy Lube” story, not to mention the silicone breast implant scare which began in the 1990s and has since been proven to be a false alarm), silicone has become a much-maligned, misunderstood, and emotionally loaded word. If you are considering silicone injections, you should understand that liquid silicone is not FDA-approved in the United States for cosmetic facial injections. Use of liquid silicone in this type of procedure is considered an off-label use. On the other hand, while silicone injections can indeed be risky in the wrong hands, there are some doctors who believe it to be quite safe and to have distinct advantages (including permanence) when used properly. Learn the truth about silicone and straighten out the myths, facts, risks, and benefits of silicone injections.

The Safest Filler of All: “Preview” Your New Nose with Saline Injections

For patients who are anxious about what the “after” will look like, and who aren’t prepared even to commit to a hyaluronic-based filler, your doctor may be able to offer you the ability to “test-drive” your new nose before agreeing to the procedure. As a demo, your surgeon can inject the areas that need filling (or increased volume and projection) with a simple saline solution. The visual result is instant, though the saline will dissipate and be absorbed by the body within just a few hours.

What you see in the saline demo, while not a guarantee of your final result, can give you a general idea of what can be accomplished with this non-surgical technique, and help you figure out which option (injections, surgery, or just leaving well enough alone) is the right one for you.

Learn More About Non-Surgical Rhinoplasty

To learn more, including risks, benefits, and how it’s done, please check out this article about non-surgical rhinoplasty.

Sources:

Adjustment of Subtle Postoperative Nasal Defects: Managing the “Near-Miss” Rhinoplasty; Anthony P. Sclafani, Thomas Romo, III,Jay G. Barnett,Channing R. Barnett; Facial Plastic Surgery, Volume 19, Number 4, 2003

Dermal Fillers, Consumer Information Sheet, American College of Osteopathic Dermatology; http://www.aocd.org/skin/dermatologic_diseases/dermal-fillers.html

Interview with Alexander Rivkin, MD; Los Angeles, CA, conducted on October 15, 2009

Interview with Robert Kotler, MD, FACS; Beverly Hills, CA, conducted on August 31, 2009

Liquid Injectable Silicone: A Review of Its History, Immunology, Technical Considerations, Complications, and Potential; Narins RS, Beer K.; Plast Reconstr Surg. 2006 Sep;118(3 Suppl):77S-84S

Product Information Sheet on Brand-Name Dermal Fillers, Liquid Face Lift Association; http://www.liquidfacelift.com/liquidfaceliftproducts.asp

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