Introduction:
The advent of dermal fillers has revolutionized the rhinoplasty procedure. Not only are these dermal filler injections safe, but they are equally effective and productive as surgical methods. As a result, nonsurgical rhinoplasty has gained popularity over the past few decades among patients with a crooked nose or other nasal deformities. In addition, it also reduces the time and cost the patient needs to bear for surgical rhinoplasty. However, though the procedure has numerous benefits, it is technically challenging, along with numerous risks or complications. Hence, doctors must perform the procedure with a clinically sound understanding of the lower nose anatomy and safe injection techniques.
Which Lower Nose Sites Are Safe for Filler Injections?
Patients who are willing to undergo nonsurgical rhinoplasty must consult the doctor for a thorough nasal examination. This is because the doctor needs to comprehend the nasal anatomy to inject dermal fillers safely and appropriately. The following skin layers of the nose are commonly observed during nonsurgical rhinoplasty:
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Skin - It is the thickest portion at the tip and thinnest at the lower end of nasal bones. People with thicker and oily skin often have problems undergoing nonsurgical rhinoplasty because it becomes difficult to insert the injection needle at this site. The risk of postoperative edema is high in such patients.
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Superficial Fat - It is a space within the nose occupied by major blood vessels.
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Deep Fat - It is an avascular area that is one of the safest sites for filler injections. Though small arteries are present in this layer, fillers can be safely injected without any complications. However, the injection must be inserted slowly, and aspiration must be done repeatedly.
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Superficial Musculoaponeurotic System - It is a thin layer of fibers and muscles occupied by major blood vessels.
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Perichondrium - It is a thin fibrous layer present over the cartilage.
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Periosteum - It is a thin fibrous layer present over the bones.
One needs to remain careful while injecting at sites having abundant blood supply. The blood supply of the nose arises from ophthalmic and facial arteries via the internal and external carotid arteries. Hence, the vasculature of the lower nose can be described below:
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Ophthalmic Artery - It gives rise to two arteries that supply the upper portion of the nose.
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Facial Artery - It gives rise to several branches that supply the lower portion of the nose.
Doctors usually emphasize injection in the avascular zone to avoid vascular occlusion, necrosis, and blindness. The doctor can obtain an elaborate nasal analysis after thoroughly reviewing the nasal anatomy. This anatomical analysis allows one to inject in the safe sites.
What Are Facial Fillers or Dermal Fillers?
Dermal or facial fillers are an integral part of minimally invasive nonsurgical procedures. There are numerous varieties of dermal fillers. Doctors usually inject these fillers in the areas surrounding the nose, mouth, and eyes. Dermal fillers work to reduce wrinkles, smoothen fine lines, and restore facial volume. The doctor usually injects these fillers under the skin. People opt for this treatment procedure to improve their features and obtain a youthful look. Though dermal filler is a non-invasive procedure, it has several risks or complications, including bleeding, bruising, or infections.
What Are the Indications of Filler Injections in the Lower Nose?
Non Surgical rhinoplasty or infusion of filler injections in the lower nose is usually done to correct minor cosmetic flaws. This procedure is specifically done for patients who want to avoid the cost, surgical trauma, downtime, and risks associated with surgical rhinoplasty. Hence, nonsurgical rhinoplasty is indicated to address the following:
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Low radix (radix is a depression near the root of the nose).
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Presence of convexity or hump on the nose.
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Concavity on the nose.
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Presence of irregularities or asymmetry in nasal contour.
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Reduced tip projection.
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Reduced tip rotation.
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Irregularities in the structure surrounding the nostrils.
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Presence of irregularities after rhinoplasty.
What Are the Contraindications of Using Filler Injections in the Lower Nose?
Before initiating the procedure, the doctor must determine if the patient is suitable for surgical or nonsurgical rhinoplasty. In addition, patients with excess nasal deviation rotated tips and irregularities in the contour of the tip might have limited benefits. Hence, nonsurgical rhinoplasty must be offered to patients willing to undergo hump reduction or irregularly positioned nasion. In addition, people with unrealistic expectations must not be recommended for this procedure. The absolute contraindications of dermal fillers include the following:
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Patients with a history of autoimmune diseases.
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Presence of bleeding disorders.
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Pregnant females.
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Breastfeeding mothers.
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Inflammation or infection at the injection site.
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Patients with a previous history of nonsurgical rhinoplasty with silicone.
In addition to the contraindications mentioned above, patients diagnosed with body dysmorphic disorder must be referred to a psychiatrist before undergoing filler rhinoplasty. Such patients have poor satisfaction related to the procedure. Filler rhinoplasty is contraindicated in patients taking the following drugs:
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Non-steroidal anti-inflammatory drugs.
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Herbal medications or supplements include ephedra, chondroitin, echinacea, or ginger.
How Does the Procedure Work?
Non Surgical rhinoplasty uses fillers to change the shape and contour of the nose. The procedure is relatively simple compared to surgical rhinoplasty. During the procedure, a gel-like substance, mainly hyaluronic acid, is inserted underneath the skin to target those areas, creating fine lines specifically. In some cases, botox might also be used. The ingredients of the injections settle in the deeper skin tissues. Hence, the patient can have an improved appearance of the nose within four months to three years, depending on the skin, outcomes, and the constituents used. The entire procedure gets completed within 15 to 45 minutes.
What Are Some of the Risks or Side Effects of Nonsurgical Rhinoplasty?
Some people often complain of sensitivity and redness at the injection site after liquid rhinoplasty within one or two days after the procedure. The additional side effects of nonsurgical rhinoplasty are listed below:
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Swelling.
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Bruising.
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A wavy or overfilled look of the nose.
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Nausea.
The nose is a delicate or sensitive organ occupied by major blood vessels close to the eyes. Hence, nonsurgical rhinoplasty is more complicated than other procedures. Some of the other serious complications are listed below:
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Vascular complications.
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Tissue necrosis.
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Loss of vision.
Some of the rare complications are listed below:
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Fever.
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Blurred vision.
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Redness.
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Hives.
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Allergic reactions.
Conclusion:
The nose is a sensitive organ and is richly supplied by a network of nerves and blood vessels. As a result, the risk of complications increases when any surgical or non-surgical procedures are performed. Hence, dermal fillers should be used cautiously to avoid any nasal complications.
