Nonsurgical Rhinoplasty: Everything You Need to Know

Non-surgical rhinoplasty is a procedure in which dermal fillers are injected into the nose to change its shape. While this procedure is quick, cost-effective, and does not involve any surgical cutting, there are risks involved. In addition, the results are only temporary.

Not everyone is a candidate for nonsurgical biopsy—it's not an option if you want a smaller nose or major changes to your nose.

If you are considering a nonsurgical rhinoplasty, learning more about the procedure and what it involves from start to finish is a good first step.

What Is Nonsurgical Rhinoplasty?

Nonsurgical rhinoplasty is a cosmetic procedure performed by a plastic surgeon or a facial plastic surgeon. Sometimes a numbing cream/ointment is applied over the skin around the nose for topical anesthesia.

During the procedure, the surgeon strategically injects fillers into certain areas within the nose. Depending on your goals, the fillers can smooth or flatten out the appearance of bumps, raise the nose bridge, fill in dips or divets, and/or improve the overall symmetry of the nose.

Results of a nonsurgical rhinoplasty are immediate but not permanent, and typically last a year or more. Patients are able to go home right after the procedure is complete.

Types of Nose Fillers

There are different types of dermal fillers the surgeon may use to perform a nonsurgical rhinoplasty.

Most commonly, hyaluronic acid fillers, like Restylane or Juvederm, are used because they can be dissolved if they are accidentally injected into the wrong spot.

Less commonly, surgeons use Radiesse (calcium hydroxyapatite), which is longer-lasting but cannot be reversed if something goes wrong.

Contraindications

Certain medical circumstances may prevent you from being a candidate for non-surgical rhinoplasty, such as:

• History of an autoimmune disease or bleeding disorder
• A known hypersensitivity/allergy to the filler or one of its ingredients
• Signs of swelling, redness, infection, or pre-cancerous/cancerous lesions near your nose
• Pregnancy or breastfeeding
• Unrealistic expectations or body dysmorphic disorder

In some cases, a waiting period or a medical treatment may be indicated before your surgeon will perform a nonsurgical rhinoplasty.

Examples of such cases include:

• If you're medications or supplements that thin your blood
• If you have a cold sore or another facial skin condition (e.g., acne or rosacea)

Potential Risks

Risks associated with a nonsurgical rhinoplasty include:

• Redness, swelling, tenderness, or bruising at the site where the filler is injected
• Hematoma (an accumulation of blood)
• Infection, including the formation of granulomas (small clumps of white blood cells)
• Unsatisfactory aesthetic results (e.g., asymmetry or lumps felt underneath the skin)
• Allergic reaction to the filler
• Scarring

While very rare, it's also possible that the filler can be accidentally injected into a blood vessel instead of underneath the skin.

If this occurs, blood flow may be blocked, resulting in skin decay and necrosis (tissue death). In addition, if the artery that supplies the retina of the eye is blocked, vision loss can occur.

Purpose of Nonsurgical Rhinoplasty

The purpose of a nonsurgical rhinoplasty is to reshape a person's nose without cutting or removing any tissue. It cannot improve breathing problems or correct internal defects, such as a deviated septum.

Patients who are potential candidates for nonsurgical rhinoplasty include those who have and are bothered by one or more of these nose features:

• Small bumps, depressions, dents, or grooves
• Low or flat bridge, dip in the bridge
• Asymmetry or crookedness
• Drooping nasal tip
• "Scooped out” or “saddle-nose” profile

This procedure may also be done in patients who are considering surgical rhinoplasty and want to get a sense of what the results might look like before proceeding with a permanent change.

A nonsurgical rhinoplasty may also be a reasonable option for patients who already underwent surgical rhinoplasty and desire minor revisions.

That said, since fillers involve injecting volume into the nose, a nonsurgical rhinoplasty is not a good choice for patients who want a reduction of a large nose. Likewise, it is not intended for major adjustments (e.g., a thinner bridge, a large bump removed, or a more narrow tip).

During the consultation visit for this procedure, the plastic surgeon or facial plastic surgeon will review your cosmetic goals and the possible risks involved.

Medical and anesthesia clearance with bloodwork or various tests (e.g., electrocardiogram) is not usually needed since general anesthesia is not used.

That said, your surgeon may recommend a consultation with your primary care physician if you are taking medications that need to be stopped before the procedure.

Plastic surgeons may also request a consultation with a psychiatrist for patients with suspected body dysmorphic disorder.

How to Prepare

Prior to your procedure, your surgeon will give you instructions on how to prepare. Not following them could result in your procedure being delayed.

Location

Nonsurgical rhinoplasty is performed in a plastic surgeon or facial plastic surgeon's office.

What to Wear

Wear comfortable clothes on the day of your procedure. To avoid accidentally bumping your nose when getting undressed at the end of the day, it's best to wear a shirt or dress that has a zipper or buttons in the front.

Food and Drink

While you do not need to fast, your surgeon may ask you to avoid caffeine and high-sodium/sugary foods a day or two prior to your rhinoplasty appointment to help minimize swelling after the procedure.

Medications

If you take non-steroidal anti-inflammatory drugs (NSAIDs), or another medication or vitamin/herbal product that thins your blood, your doctor might ask you to stop it around a week prior to your procedure.

Around two days beforehand, your surgeon will also ask you to stop applying Retin-A if you use it. If you have a history of cold sores, you will be prescribed an anti-viral medication to take.

What to Bring

On the day of your procedure, bring your driver's license and a form of payment.

Pre-op Lifestyle Changes

Your surgeon will probably ask that you not schedule any vaccination or medical, dental, or cosmetic procedures (e.g., colonoscopy, dental cleaning, laser skin resurfacing) for the two weeks leading up to your appointment.

What to Expect on the Day of Your Procedure

On the day of your nonsurgical rhinoplasty, you will arrive at your surgeon's office and check in. You may need to show your ID and make a payment at this time.

Before the Procedure

After checking in, you will be taken to a procedure room. A nurse will sit with you, review your medication list, and record your vitals.

Your surgeon will then come to greet you and review the specifics of the procedure, the expected outcome, and the potential risks, including the possibility of unsatisfactory results. You may need to sign a consent form at this time.

Next, your surgeon will use a special pen to identify and mark key sites on your face. These marks will serve as guiding points as the fillers are being injected. Photographs of your face may also be taken for before/after comparison.

Lastly, a nurse will clean and disinfect your skin and apply a numbing cream/ointment around the area of your nose if you're having local anesthesia. You will relax in the procedure room for around 20 minutes while the numbing medication takes effect.

During the Procedure

The procedure will take around 15 minutes to complete.

The surgeon may inject into different areas in and around your nose depending on the aesthetic goals.

Example injection sites include:

• Above and below a bump/hump in the nose to improve the angle between the nose and forehead
• Near the columella (the tissue that separates your nostrils at the bottom of your nose)
• Around the tip of the nose
• Above the upper lateral cartilage of the nose

As you are receiving the injections, you may feel a slight pinching or pressure sensation. In between injections, your surgeon may massage the skin of your nose to help achieve the desired shape.

Once all the injections are given, the surgeon will place an ice pack over your nose to help reduce any immediate swelling or discomfort.

After the Procedure

After you discuss any questions or concerns that you have about your procedure, you can leave your surgeon's office.

It's normal to feel mild numbness or tenderness over your nose and experience some swelling or redness for a day or two after the procedure.

Bruising may also occur, and it should resolve within a week or two.

Recovery

After a nonsurgical rhinoplasty, your doctor will give you instructions to follow at home.

These instructions generally include:

• Avoid vigorous activity or movement/massage/rubbing of the injection sites for 24 hours after the procedure.
• Apply ice packs or cold compresses to your nose for 10 to 20 minutes every hour for the first day or two after the procedure.
• Sleep with your head elevated for one night.
• Avoid the sun, alcohol, or salty foods after surgery to help minimize swelling and redness.
• Take Tylenol (acetaminophen) as needed for any discomfort.

If the bridge of your nose was injected, you may also be asked to avoid wearing goggles, sunglasses, and/or eyeglasses for around two weeks or more.

Double-check with your surgeon, but most patients can apply make-up and shower within one to 24 hours after the procedure.

Follow-Up

You can expect to see your surgeon a week or two after your nonsurgical rhinoplasty.

During this appointment, they will review your results and monitor you for complications. If some nose "tweaking" is needed, your surgeon may inject a bit more filler at this time.

Pictures will also likely be taken to at this visit. Your surgeon will likely show you them alongside your "before" pictures, so you can get a good sense of the results.

Possible Future Procedures/Surgeries

Since a nonsurgical rhinoplasty is not permanent, the procedure needs to be repeated every one to two years if you want to maintain your desired nose shape.

Rarely, surgery may be warranted if a serious complication like skin necrosis occurs.

A Word From Verywell

Whether you can’t afford the expense or recovery downtime associated with surgical rhinoplasty, or you are simply hesitant or anxious to undergo such a permanent "fix," it can be quite a relief to hear that a nonsurgical option for altering your nose is available.

That said, if you are considering the procedure, it's essential to make sure that your plastic surgeon or facial plastic surgeon is experienced in performing it and is board-certified by the American Board of Plastic Surgery or the American Board of Facial Plastic and Reconstructive Surgery. Expertise and credentialed training are key to ensuring a safe and optimal outcome.