22 July 2020
There are 2 main ways to enhance the shape and height of a nose bridge and nose tip without surgery: nose fillers and the Hiko nose threadlift. Both types of non-surgical rhinoplasties remain popular in Singapore and Asia because both these treatments offer immediate enhancement of nose definition without requiring any disruption from daily activities or work.
The Hiko nose threadlift has been covered extensively here in this post, Hiko Nose Threadlift: All You Need to Know and this post is review on the essentials on nose fillers and non-surgical nose enhancement. Let’s start with the basics of nose fillers!
Nose fillers are an effective way to correct deformities and asymmetries in the nose without going under the knife. For example, dorsal humps on the nose bridge (frequently referred to as ‘bump’) can be concealed with fillers.
Nose fillers are also commonly used to add elevation and definition to flat and low setting nose bridges. When injected into the nose tip, nose fillers can enhance the projection, support and definition of the nasal tip.
For patients who have undergone nose surgery (rhinoplasty or septoplasty) and suffered a complication called saddle nose (a deformity where the nose bridge sinks downwards due to excessive cartilage removal); nose fillers are one way to correct the saddle and elevate the nose bridge
Upon injection of dermal fillers into the nose bridge or nose tip; the results are immediate. Nose fillers, add volume to areas that are deficient. In other words, a flat and nose bridge can be transformed into a higher and slimmer nose bridge with improved nasal definition. Nasal tips that are weak, deficient and short can benefit from fillers to improve their projection so that the nose tip looks less bulbous.
Unlike the Hiko nose threadlift which also the appearance of the nose bridge and nose tip, dermal fillers conventionally used for the nose contain hyaluronic acid and do not have the advantage of stimulating new collagen formation in the nose.
The most common type of dermal fillers used for the nose are gels that contain hyaluronic acid. Hyaluronic acid is commonly found in dermal fillers. There are various brands of fillers and each brand and type of dermal filler has its own properties. My preference for nose fillers is Restylane Lyft because it has a ‘harder’ consistency, making it feel the nose feel firmer and defined after injection of the filler. Most hyaluronic acid based fillers can last 9-12 months.
There are also permanent nose fillers available; however it is not my practice to inject permanent nose fillers because of the risks associated with nose fillers.
There is a second, and newer type of dermal filler which can be considered as an in-between traditional hyaluronic acid dermal fillers and nose threadlifts: Collagen Biostimulators. Collagen biostimulators, as their name suggests, stimulate collagen formation along where they have been injected. Examples of collagen biostimulators are Ellanse (Poly Caprolactone) and Radiesse (Calcium Hyroxyapatite). The volumizing properties of collagen stimulators (i.e. ability to add immediate definition and improvement in the nose bridge and nose tip) are less with collagen biostimulators compared to hyaluronic acid type of nose fillers. Collagen biostimulators (both Ellanse and Radiesse) can last for at least 2 years.
If you would like to learn more about dermal fillers in general, please read What You Should Know Before Getting Fillers, where I shared answers to FAQ about dermal fillers in Female magazine.
You can resume your daily routine, work, skincare, diet and makeup after nose fillers, except for 2 main exceptions.
Firstly, avoid drinking alcohol for the first week. Alcohol has a vasodilatory effect and this increases blood flow to the face and can worsen any bruising.
Secondly, nose fillers as with all dermal fillers, need 3 days to 2 weeks to stabilise or ‘fix’ the position and shape of the nose fillers. If the nose filler is moved, say due to facial massage, facial or during exercise, before the shape and position of the nose filler has been fixed, the position of the filler will change and the nose can look asymmetrical or distorted. If this side effect of nose filler occurs, you will need to see your doctor as soon as possible for the nose filler to be moulded back into shape and position.
Commonly, there may be transient redness, swelling, bruising and discomfort after injection of the nose filler, as with any injection or blood taking procedure. These are transient reactions and are not considered complications.
Just like injection of dermal fillers into the face, nose fillers can be associated with more common side effects and complications like asymmetry and under- or over- correction. The less common, but most feared complications with nose fillers are the accidental blockage of blood vessels by the injection of dermal fillers. When blood vessels are blocked, blood supply carrying oxygen and essential nutrients for the part of the nose supplied by the blood vessel is compromised. This leads to a complication of dermal fillers called ischemic necrosis; i.e. the tissues dying off and turning dark due to lack of blood supply.
Arterial supply of the nose and eyes.
Another dreaded complication of nose fillers would be blindness. This happens when the blood vessels that supply the eye get blocked due to the proximity of the blood vessels of the nose and the eyes. When nose fillers go wrong, blindness can result as a complication.
When these complications occur, it is a medical emergency to reverse the treatment of injection of nose fillers. One of the steps is to remove or to ‘dissolve’ the filler with an enzyme called Hyaluronidase or Hyalase as an ‘antidote’ for hyaluronic acid type of nose fillers. For both types of collagen biostimulator type of fillers- Ellanse (Polycaprolactone) and Radiesse (Calcium Hydroxyapatite)- there is no antidote to reverse the complications of filler if they occur, unfortunately. Another complication of nose fillers is the broadening of the nose bridge that occurs over time.
Avatar effect in a patient (picture above); this patient had her nose filler was NOT done by me. This is due to the sideways movement of the nose filler. This spreading of the nose filler causes an ‘Avatar effect’. You can read more about what happens when dermal fillers are overdone or gone wrong in this blogpost Fillers Gone Wrong: Telltale Signs of Too Much Filler Injections.
A safer alternative to nose fillers for non-surgical nose enhancement would be a Hiko nose threadlift. I have a detailed writeup about the Hiko nose threadlift and the differences between the Hiko nose threadlift vs nose fillers in this post, Hiko Nose Threadlift: All You Need to Know. Essentially what makes the Hiko nose threadlift safer than nose fillers is that the threads do not penetrate blood vessels and so, the risk of causing occlusion of blood vessels, ischemia and blindness as complications do not occur with a Hiko nose threadlift.
And there you have it, nose fillers explained in this guide. Nose fillers are generally a safe and effective way to sculpt the nose and correct deformities like nasal humps. There is almost no downtime and instant results with nose fillers. This is why nose fillers are also known as the lunch time nose job as patients can return to their jobs and daily activities after getting a nose filler.
Related posts on dermal fillers:
Despite the rising popularity of the Hiko nose threadlift because of its safety and lower complication rate than nose fillers, nose fillers still remain popular in my practice in Singapore. Nose fillers can also be combined with the Hiko nose threadlift for enhanced results as both types of non-surgical rhinoplasties have their respective advantages.