With increased interest and use of compounds used to fill in facial wrinkles and depression, it was inevitable that such techniques would finally be applied to augmentation rhinoplasty. While the history of nasal injection with earlier products was disastrous, modern dermal fillers are designed to be more bio-compatible if used properly.

Most commonly, non-surgical, or petite, rhinoplasty entails injection using one of the longer-lasting filler materials like Radiesse ® (calcium hydroxyapatite) or permanent fillers like ArteFill ® (polymethylmethacrylate beads within a collagen suspension) to build up the flattened nasal dorsum, elevate the bridge, and smooth out mild depressions and bumps. Injection works poorly the tip because the tissues are tight and resistant to expansion.

In the Asian nose, injection rhinoplasty can raise the loose tissues of the bridge. If the nasal tip is short but not altered, however, doing this can make the nasal tip appear even shorter.

Treatment and recovery are much faster than with invasive surgery, but results are usually less than amazing and fleeting (sometimes a matter of months) while recurring costs can be high.

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While seemingly simple, such treatments come with definite risks, including granulomas, infection, pain, ongoing swelling or redness, and permanent skin deformity, scarring, or contracture. Since blood supply to the nasal tip is limited, this area is more sensitive to necrosis, or tissue death, after filler injection.

Especially if injected too superficially, the skin of the nose may become red, lumpy, and, in some cases, so damaged and thinned that surgical removal is too risky. While such problems are more common with the long-lasting fillers, they may even occur with shorter acting hyaluronic acid preparations.

Nasal contouring can also be done by injection of one's own fat obtained by liposuction, but the results and longevity are not at all on a par with actual rhinoplasty surgery.

Many surgeons "pushing" injectables as an alternative to surgical rhinoplasty are neither nose specialists nor maxillofacial plastic surgeons but rather dermatologists or other "non-core" generalists looking to enlarge the scope of their cosmetic practices. Since they are unfamiliar with surgical rhinoplasty and sometimes even the details of nose anatomy, they tend to over-recommend non-surgical treatment as a harmless "one size fits all" treatment.

Update: Injectable Fillers Not Recommended as First-Line Option in Nasal Reshaping

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