Liquid Rhinoplasty

Liquid Rhinoplasty is another term for non-surgical rhinoplasty. Correction of certain nasal imperfections, most commonly employed after one or more imperfect rhinoplasties, leading the patient to need revision rhinoplasty. It can also be employed as a primary procedure for noses that have genetically-endowed unsatisfactory features.

What Is Liquid Rhinoplasty?

Liquid rhinoplasty is the injection of a liquid by a syringe and fine needle into the external nose, between the skin and underlying bone/cartilage to correct dips, divots, or asymmetries. It is a “ filler”. Liquid rhinoplasty is akin to pumping air into a flat tire. Or, applying “Bondo” to correct an auto ding or dent. The result is immediate and obvious. There are no additional changes that take place.

The #1 Misconception Patients Have About Liquid Rhinoplasty

The most common misconception about liquid rhinoplasty is that only temporary nose fillers exist. Rather, liquid rhinoplasty fillers fall into two classifications: temporary and permanent non-surgical rhinoplasty. The only accepted permanent liquid rhinoplasty is medical grade liquid silicone, marketed most commonly as “ Silikon-1000” by the Alcon Corporation. There are many brands of temporary fillers such as those known for plumping lips and cheeks, e.g. Restylane®, Juvéderm®.

Unfortunately, the heavy advertising and marketing by the temporary filler companies has the public believing their temporary products are the only available fillers. Medical grade silicone used for liquid rhinoplasty has been available for over 50 years.

How Long Does Liquid Rhinoplasty Last?

Liquid rhinoplasty can last forever, but only with the right nose surgeon. Most surgeons practice temporary nose jobs, but there are a handful of nose surgeons like Dr. Kotler experienced permanent non surgical nose job technique

The duration of temporary fillers depends on the nature of the product and the volume injected. Some last longer than others. The range is generally four months to one year.

The silicone filler used for our liquid rhinoplasty is permanent, just like the solid silicone appliances and parts inserted into the body for medical reasons: artificial heart valves and joints; pacemakers, by-pass grafts. Man-made silicone is the premier bio-engineering accomplishment of our time. 


Pros and Cons of Liquid Nose Fillers:

Non-Surgical Liquid Rhinoplasty Advantages

  • Can be substitute for rhinoplasty.
  • May be alternative to revision rhinoplasty surgery.
  • Certainty of outcome. “What you see is what you get”. Patient participates
  • Virtually painless. Anesthetic ointment applied prior.
  • Temporary or permanent FDA-approved fillers*, including medical grade liquid silicone (50+ years use in  U.S.) available.
  • A “demo, using sterile saline (salt water), demonstrates the anticipated result.
  • Fraction of the cost of surgery.
  • Can be performed following correction deviated septum or other procedures to correct breathing problems.

Non-Surgical Liquid Rhinoplasty Disadvantages

While “ disadvantage” may not be the ideal term to relay any negatives about silicone as a liquid rhinoplasty vehicle, those who are not certain as to their desire to permanently solve their nose unhappiness may harbor some worries. It cannot be completely removed if there is dissatisfaction.

There is an excellent “ hedge” against this only realistic “disadvantage” of injecting a permanent liquid filler: The Kotler Saline Demo. Sterild salt water is injected, mimicing the effect of the permanent filler. The mirror-holding patient sees exactly what the end result of the permanent filler will be. And, decisions of “ where and how much” are made jointly by doctor and patient before and even during the session. It’s a very nifty test drive, sneak preview. Photos are taken before and after so the patient can review. Makes perfect sense for those who will be more comfortable to see the outcome immediately. Liken it to computer imaging for those considering surgical rhinoplasty.

Liquid Rhinoplasty vs Surgical Rhinoplasty

Liquid rhinoplasty, permanent or temporary has strict limitations. It cannot improve an internal breathing problem. It cannot make any part of the nose “ smaller”. Surgery is appropriate when there is “ too much nose”, with or without a breathing problem. Liquid rhinoplasty is the technique of choice when there is “ too little “ provided by Nature or too much was removed during one or more prior rhinoplasties.

Am I a Good Candidate For Liquid Rhinoplasty?

Ideal Candidates for Liquid Rhinoplasty

  1. Prior unsuccessful rhinoplasty or rhinoplasties
  2. Congenital deficiency of certain portions of nose. The most common is a very low bridge in Asian patients. 
  3. Small “ bump” on bridge, often from an accident
  4. Minor crookedness or asymmetry of the nose.
  5. Odd-shaped nostrils

Ideal Candidates for Surgical Rhinoplasty

  1. Large nose; disproportional to other facial structures
  2. Severely crooked nose that likely also had breating and/or sinus problems.
  3. Internal nasal blockage accompanied by bulbous tip, bump, 
  4. Nose that sits too close to upper lip
  5. Nose tip depresses and thus lengthens with smiling.

Liquid Rhinoplasty: The Procedure

Is Liquid Rhinoplasty Safe?

Liquid rhinoplasty (properly performed by a highly specialized, long-experienced specialist) is considered safe. Both medical grade silicone and the temporary fillers are FDA-approved. Significant complications and minor problems are generally related to the technique, not the products. Hence, the imperative that the doctor be highly qualified to perform the procedure.

Before And After Liquid Rhinoplasty

In our practice, the procedure with the highest percentage of happy patients and the lowest percentage of complications is the medical grade liquid rhinoplasty or revision liquid rhinoplasty. Some patients present with having even four or more unsuccessful rhinoplasties. 

The dissatisfaction with an unhappy results tends to occupy a certain part of the brain’s volume. It does not go away and is a constantly brought to consciousness when looking into the mirror. It is a huge psychological burden that never disappears. 

Patients are almost incredulous that they have discovered a practical, safe, predictable and affordable answer to their unhappiness. Certainly those who wisely chose the permanent solution.

The Price Of Liquid Rhinoplasty: Nose Filler Costs Explained

Liquid rhinoplasty fillers do have an economic disadvantage. The process knows no end, so the cost could eternal. Conversely, the cost of the permanent is generally a fixed cost, for all sessions, so there is no mystery and there is a finite conclusion to the problem. 

Since the cost of the permanent filler is a known and fixed, as a comparison, it is typically 20-25% of the cost of a surgical rhinoplasty or surgical revision rhinoplasty.

Financing, as with surgery, is available. Our offices accept credit cards

Liquid Rhinoplasty: Recovery

Liquid rhinoplasty, temporary or permanent, has no recovery time needed. Patients can get back to work without any evidence of an intervention. The permanent variety is done in stages, six weeks apart. That technique, using micro-droplets to gradually achieve the end result is considered wise and prudent. Three reasons. Nature will be less likely to notice this man-made material resting under the skin when the injection volumes are small. The second reason is that as the process progresses, during the six-week interval between injections, the patient has ample opportunity to decide which areas need attention and how much. Again, because the permanent variety of liquid filler is permanent and not easily removed, attention must be given to one’s tastes and desires. That leads to the obvious third reason: overfilling must be avoided. For more information about about rhinoplasty recovery see our rhinoplasty recovery guide. 

An anesthetic ointment is applied to the skin prior and may be applied at home or en route to the office 45 minutes prior to appointment to save time.

Bruising, swelling is very rare, since the amount of the permanent liquid  injected in a given area is so minute—0.02-0.04 cc. That is a tiny volume. Temporary fillers are deposited, generally, to completely fulfill the mission at one sitting. 

Liquid Rhinoplasty Side Effects: When To Call Your Doctor

After the liquid rhinoplasty procedure, if you develop any pain, redness, swelling, severe bruising, change of skin color, a fever, or chills, contact your doctor. Infections are extremely rare, as is bleeding but, if anything seems out of synch, call your doctor. And, don’t spend your time looking for advice on the Internet.

Finding the Best Liquid Rhinoplasty Surgeon

When researching liquid rhinoplasty, temporary or permanent, one is best served by seeking a “ super-specialist in the field.  Many plastic surgeons, facial plastic surgeons, and dermatologists offer temporary fillers. Many are comfortable with them because they have experience with their use as cheek and lip fillers. The nose is a different territory so important to ask about experience with “nasal fillers”, specifically.

The permanent variety, has very few practitioners offering it. Many reasons that go beyond the scope of this report but the fact is that the permanent filler technique must be taught to a trainee by an expert and then as the trainee migrates in to practice, long experience is a prerequisite for excellent. 

I am proud to share that I had the great fortune to be trained by one of the original practitioners of the permanent non-surgical or liquid rhinoplasty technique. Happily, early in my career so I bring to our patients over 40 years experience and thousands of injections. Expertise does count.

Today, permanent liquid rhinoplasty, as a primary procedure or to correct imperfect surgical results, is 25% of our practice. Patients do come from all over the US and even from overseas for a permanent solution to  a long-standing dissatisfaction. Thus, is it very gratifying to help them overcome their unhappiness and move on with their life.