Will a liquid rhinoplasty make my nose look bigger?

I have a drooping tip which, from what I understand, can be solved easily with a non-surgical procedure. However, if a doctor injects fillers into the nose, won't it look bigger?


F, 29, Illinois

Tags:woman age 25-34 non surgical

Dermal fillers can offer an excellent short-term, subtle improvement to the nose. They are most commonly and successfully injected to disguise small deformities such as humps in the bridge of the nose. They are used to a lesser degree to correct slightly drooping nasal tips. This is because injecting the nasal tip area requires specialized expertise, as there is no solid foundation to lay the filler on. In addition, there is the risk of vascular compromise and blocked blood supply to the area, which can result in skin necrosis of the nasal tip.

Essentially, dermal fillers create the illusion of rotation of the nasal tip by injecting volume into the area. As you mentioned, the nose will look a little bigger as a result, but if successfully performed, there will be less drooping and enhanced facial harmony.

Some surgeons have experienced success in correcting drooping nasal tips by injecting Botox. Often, many droopy nasal tips are caused by overly strong facial muscles, such as the depressor septi muscle which connects the nose with the upper lip. Strategically placed Botox injections selectively weaken the muscle that draws the tip down, relaxing the muscle and reducing the appearance of droop.

It is also possible to combine both dermal fillers and Botox to give the illusion of a lifted tip. If a minimal lift is required, with the right candidates this short-term non-invasive method can be a successful alternative to rhinoplasty surgery. Non-surgical treatment cannot rotate the nasal tip, however. Only cosmetic surgery can offer a lasting and dramatic improvement for patients with significant droop. Surgery removes and repositions tissue to lift the tip without adding volume and makes the nose appear smaller overall. Tip rhinoplasty can be performed as an open approach which requires an incision on the columella (skin between the nostrils) or as closed rhinoplasty performed through incisions on the inside of the nostrils.

The tip of the nose has several aesthetic features rhinoplasty can alter. The procedure can create significant change in the aesthetics of the nose by increasing or decreasing the projection of the tip, the rotation of the tip, the angle between the tip and upper lip, and the width of the tip. I recommend that you consult a rhinoplasty specialist to see which procedures you may be a candidate for.

Non-surgical rhinoplasty requires considerable experience on the part of the surgeon as it is a technically demanding procedure with considerable risk involved. Only plastic surgeons who are very familiar with nasal anatomy and the blood supply to the nose should perform non-invasive rhinoplasty. If too much dermal filler is injected into the wrong area, issues with blood supply to the skin can arise, resulting in skin necrosis. However, in the hands of a plastic surgeon who specializes in the procedure, good results are possible, and facial harmony can be subtly improved.

In general, the best candidates for a non-surgical nose job are those who want to conceal a hump in the nose, raise the bridge of their nose, or achieve more symmetry in general, as fillers can help straighten the appearance of the nose. While dermal fillers result in a larger nose because they add volume, it often looks smaller because it’s more balanced as a result of strategically placed injections.

It is very challenging to use fillers to raise the tip of a droopy nose. Some facial plastic surgeons prefer to avoid this procedure, particularly if the droop in the tip is pronounced. Better results can be achieved through invasive nose surgery.

Rhinoplasty surgery can raise the tip of the nose by cutting the depressor septi muscle which connects the base of the nose with the upper lip. Patients with very strong depressor septi muscles often have droopy nasal tips and short upper lips. Facial animation results in the tip being pulled downwards. A hidden incision can be made in the gum of the upper lip or internally in the nose to cut, reduce or detach this muscle. This may be accompanied by other techniques to create a natural looking nose and enhance the facial features overall.

Another method of correcting a droopy nasal tip is trimming the septum. A shorter septum allows the tip cartilage to be rotated in a more upward direction before being reattached. The nasal tip is lifted as a result of this procedure. Consider consulting with a cosmetic surgeon who specializes in rhinoplasty to determine the best treatment to achieve your goals.

Fillers are a very effective way to filling in the bridge of your nose to help minimize a depression  or asymmetry. 

My experience is that fillers are not the best way to lift the tip. You would do better addressing this surgically.