Non-surgical rhinoplasty: Compare practices from our network

A non-surgical rhinoplasty, sometimes called a liquid nose job, uses carefully placed dermal filler to change how the nose looks in profile, without incisions or general anesthesia. Small amounts of filler can disguise a bump on the bridge, add support to the tip, fill small dips and make the nose look straighter.

Filler can only add volume. It cannot make a nose smaller, narrower or shorter, and it cannot improve breathing. A bump is camouflaged by building up the areas around it, so the nose can look smoother while being slightly larger overall. The nose is also considered a higher-risk area for filler because of its blood supply, which is why experience matters so much here.

A non-surgical rhinoplasty can:

• Camouflage a small bump on the bridge
• Lift or define the tip
• Raise a low or flat bridge
• Fill small dips and improve minor asymmetry
• Smooth minor irregularities after a previous surgical rhinoplasty, with extra care

Filler works by adding volume. It cannot:

• Make the nose smaller or narrower, which needs surgery.
• Improve breathing, which needs surgery.
• Make major changes to the tip, which is also a higher-risk area.
• Last permanently, so keeping the result means repeat treatments.

Consultation. Your injector looks at your nose in profile and from the front, in relation to your forehead, lips and chin, and talks honestly about whether filler can achieve what you want or whether surgery is the better match. Ideally this is someone who understands both approaches. In Sweden, cosmetic injections require spoken and written information and a reflection period of at least two days.

Preparation. Avoiding alcohol and blood-thinning supplements beforehand reduces bruising. Tell your injector about any previous nose surgery or filler.

Numbing. A topical anesthetic is applied, and many fillers contain a small amount of lidocaine.

Injection. Small amounts of hyaluronic acid filler are placed with a fine needle or cannula, and the shape is checked and adjusted as the injector works. The treatment usually takes 15 to 30 minutes.

Mild swelling or bruising may last a few days, and most people return to normal activities the same day. The result refines over one to two weeks as swelling settles and the filler integrates.

• Avoid heavy glasses or sunglasses for about a week, so they don't press on the filler
• Avoid pressing or massaging the nose unless your injector asks you to
• Watch for the warning signs below in the first days, and call the clinic at once if you notice them

Review. A follow-up after about two weeks allows small adjustments.

The change is visible straight away and settles over one to two weeks. Because hyaluronic acid filler is gradually broken down, the result is temporary: commonly around six to eighteen months, depending on the filler and the person. Keeping it means repeat treatments, often every nine to twelve months.

Hyaluronic acid filler can be dissolved with an enzyme called hyaluronidase, so the result can be adjusted or reversed. Repeated filler doesn't usually prevent a surgical rhinoplasty later, although it can occasionally leave some firmness or minor scar tissue.

Most side effects are mild, but the nose is a higher-risk area for filler. Everyone considering this should understand one rare and serious risk:

• Vascular occlusion, rare but serious, when filler enters or blocks a blood vessel. In the nose it can cause skin damage and, in rare cases, blindness. It is time-critical and treated with hyaluronidase.
• Swelling and bruising, common and usually settling within a few days.
• Asymmetry or irregularity, the shape may need fine-tuning at follow-up, or dissolving.
• A slightly larger nose, because volume is added, the nose can look a little bigger overall even as the profile looks smoother.
• Infection, uncommon, and treated promptly by the clinic.
• Higher risk after surgery, if you have had a surgical rhinoplasty, the blood supply has already been altered, and complications can be more likely.