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Non-Surgical Rhinoplasty vs Surgical Rhinoplasty: What’s the Difference?

Facial symmetry is an important part of beauty, and the nose is an important part of facial harmony.  Concerns about how their nose looks is common for many, and rhinoplasty (or surgery to change the appearance of the nose) is routinely in the top 3 most popular cosmetic surgical procedures in the United States.   While surgical rhinoplasty is well established–and dates back to the techniques describes by Dr. Jacques Joseph in 1887, lots of patients are very interested in non-surgical options these days, often asking about the option of nonsurgical or liquid rhinoplasty.  There are multiple factors that differentiate surgical rhinoplasty from the non-surgical or “liquid” rhinoplasty. Read on to learn about these treatments and their differences in detail.


How is non-surgical rhinoplasty performed?

A non-surgical rhinoplasty is a minimally invasive treatment which harnesses the power of injectable dermal fillers and muscle-relaxing medications such as Botox and Dysport.  When performing a nonsurgical rhinoplasty or a so-called liquid nose job, Facial Plastic Surgeon Dr. Inessa Fishman uses volumizing facial filler to fill in divots, camouflage nose humps by putting filler volume around them, and create the illusion of a more upturned nasal tip.  She also commonly employs the muscle-relaxing Botox and Dysport injections to decrease the pulling down effects of a muscle below the nasal tip, and sometimes uses the same medication to decrease the nostril flare.  “The modern iteration of a liquid rhinoplasty is relatively new and has really exploded in popularity with the help of social media,” says Dr. Fishman, explaining that hyaluronic acid-based dermal fillers like Restylane have made nonsurgical rhinoplasty more attainable than ever.  This procedure does not require much time and can typically be performed in 15-20 minutes, with the help of numbing cream and laughing gas (or ProNox) for nervous patients. There is not typically much pain after this treatment, and most patients report approximately 2-3 days of mild swelling which does not typically prevent them from returning to work or social situations.  The main drawback of the nonsurgical rhinoplasty is its subtlety; the procedure cannot drastically change the appearance of the nose. It is only able to create the illusion of a smaller or more contoured nose as well as camouflage a small-moderate nasal bridge bump. As the nonsugical rhinoplasty procedure creates a temporary solution, maintenance is usually required every 1-2 years.


How is surgical rhinoplasty performed?

A surgical rhinoplasty involves the surgical reshaping of the bones, cartilage, and skin and soft tissue which make up the nose, and it is a greater investment in both treatment and recovery than its non-surgical counterpart. During surgical rhinoplasty, patients receive general anesthesia to go to sleep, and also get injected numbing medicine during the procedure.   During nose surgery, Dr. Fishman contours the nasal bones to narrow or straighten them; corrects deviations in the nasal septum; contours and reshapes the nasal tip by reshaping its cartilages and implanting cartilage grafts to change the tip’s rotation; and builds up or takes down the nasal bridge; and sometimes narrows or reshapes the nostrils.  The surgery takes 3-4 hours, and maybe as long as 7+ hours long in cases of complex reconstruction requiring lots of cartilage grafting and borrowing cartilage from the rib or ear.  The recovery time for surgical rhinoplasty can take up to a full year and is thus much lengthier than a non-surgical procedure. While much more time is necessary for a surgical rhinoplasty, the results are permanent and the nose can be restructured to satisfy the aesthetic desires of the patient on a long-term basis. Furthermore, only surgical rhinoplasty can change the nasal septum and improve the nasa airway.


Surgical rhinoplasty vs. non-surgical rhinoplasty

Both non-surgical rhinoplasty and surgical rhinoplasty have their advantages and drawbacks.  Non-surgical rhinoplasty may take less time and have a shorter recovery, but it may not able to provide drastic structural changes and has results which only last up to a year. Surgical rhinoplasty takes more time and is associated with a longer recovery, but is able to change the physical structure of the nose in permanent and significant ways.  Whether the non-surgical or surgical option is better for any person is difficult to say without a clear understanding of that person’s treatment goals and a great appreciation of their anatomy, says Dr. Fishman.  Non-surgical options may be more suitable for those who have minor imperfections in the nose that they would like to camouflage; or for patients who want to “trial” what a different nose looks like. Surgical options may be better for patients who need reduction in volume of the nasal structure, or a significant change in the rotation of the nasal tip, relates Dr. Fishman. 

Thinking about making a change to your nose’s appearance?  Contact us today to schedule a consultation today with our expert Facial Plastic surgeon.

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