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Fillers in small quantities can treat nose deformities and can fine-tune a nose after surgery. In addition, patients who do not desire surgery or who are not surgical candidates can benefit from nose fillers, bump removal, and bridge slimming.
• Administration Technique
When injecting a low area of the nose, it is best to start deep on the bone or cartilage and administrater with a threading movement.
A nose bump can be straightened by injecting above and below the bump to straighten the nose profile. For a wide nose, administration should be placed along the nose ridge to give the illusion of a higher and narrower nose profile. The reshaping needle should be used to remove the nose bump or to slim a wide bridge.
Saddle Nose Deformity
To correct a saddle nose deformity, administration should be placed to produce a smooth, straight profile from the nose bone to the nose tip.
A twisted nose will usually wind in a C or S shape onto either side of the midline. Filling in the low spots will cause the nose to appear straighter.
Drooping Nose Tip
When there is a droopy tip, a more defined tip can be created by placing filler depot instillations into the low area of the nose. The filler can better define the tip of the nose.
If there are large pores in the area being instilled, the needle should be passed deeper to prevent filler from ejecting through the pores.
Overinstillation of a given area can cause blanching or compression of the blood vessels in the area.
• After Care Instructions
Ice and pressure help to prevent bruising. Hyaluronic acid in the nose will swell and feel firmer during the first week, and then the gel will blend in more naturally within 2 to 4 days.
Fig. (a) Nose bump. Filler can be placed above and below a bump to straighten the side profile. (b) Saddle nose. A low area of the nose, seen in the saddle nose deformity, can be improved with filler.
Fig. 46.1 (c) Crooked nose. Filler should be placed along the bone or cartilage in the inside aspect of the nose sidewall to give the appearance of a straight nose. Administrations along the right nose sidewall improve a mildly crooked nose.
Fig. 46.(d) Droopy nose tip. Filler can be used to raise up a droopy nose tip.
Fig. (a) Mild right lateral nose sidewall depression after a surgical nose correction. (b) Improvement of right sidewall depression by placing filler in the low area.
• Administration Tips
Under-correction is recommended for the nose. Patients who have previously had a surgical nose job often have a compromised the blood supply to the nose skin.
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