The only filler recognized as permanent is medical grade liquid silicone. The most common product is marketed as Silikon-1000. This clear, colorless, thick, oil-like filler is injected via a small bore, short needle. This allows precision and accuracy. It is a permanent nose job because it is not digested by the body any more than artificial joints, heart valves and catheters, made of solid state silicone. The body accepts this material, does not reject it and walls it off with a microscopic fence and thus its takes up permanent residence just under the skin of the nose. Very few Doctors perform the Permanent Non-surgical Revision Rhinoplasty. Dr. Kotler is among the most experienced Permanent Non-surgical Rhinoplasty doctors in the world.
The temporaries are better known because many more doctors use them and there are several different kinds. Restylane® and Juvéderm® are names familiar because of their original role to plump lips and replace facial fat volume that parallels age.
When the nose is imperfect after a rhinoplasty, it is usually because there is a defect in the cartilage and bone framework. Perhaps Nature shrank some of the tip cartilage and now there is a divot that is obvious to the eye. Asymmetries like that are highly visible. If there, must there be a second operation?
As a substitute for revision rhinoplasty, here are the key features of a permanent non-surgical revision rhinoplasty:
As a substitute for revision rhinoplasty, here are the key features of a Permanent Non-surgical Revision Rhinoplasty:
When a patient comes to us for consultation, whether considering a cosmetic nasal procedure or to ask about a revision rhinoplasty, the first question I ask myself is: “ Can I help this patient without surgery? Could the patient be satisfied with the Permanent Non-surgical Rhinoplasty or if there has been one or more visits to the rhinoplasty operating room, relief of dissatisfaction without another surgery by employing the permanent non-surgical option.
If I see that non-surgical rhinoplasty is a better answer, I will fortify my suggestion by showing the result with computer imaging or even better suggest the “KOTLER SALINE DEMO”. This “test drive” or preview is a practical and quick way for the patient to see, mirror in hand, the result of the permanent non-surgical revision rhinoplasty. The saline, sterile salt water, injected under the skin, under a topical skin anesthetic, will demonstrate to the patient the result of the permanent filler. If the patient likes what she or he sees, the likelihood of success is very high. Photos are taken before and after so the patient may examine the result in the quiet and comfort of home. There is no better way to appreciate what can be done without another surgical rhinoplasty.
When patients are aware of the option of having a secondary nose job, but with fillers, as opposed to another surgery, their eyes light up. This is particularly true with the permanent liquid rhinoplasty.
The decision between a second or revision rhinoplasty or correction via the permanent non-surgical revision rhinoplasty rests on the examination whereby the surgeon determines if all factors considered, the filler can achieve a satisfactory result. Factors influencing the decision are:
Our office provides computer imaging because we feel a consultation without it has little value. Shouldn’t the patient see a predicted outcome that will satisfy him or her. Otherwise, it is all talk; abstract. The surgeon’s computerized portrayal of the outcome must be achievable by his/her hands. Not fair to show a result that the surgeon is incapable of achieving. The computer imaging is a joint session, surgeon and patient, where agreement upon the desired and achievable result take place.
We have offered computer imaging since 1989 when the computer technology became available. And, happily, no patient has ever been unhappy because there was a mismatch between the computer image and the outcome.
Non-surgical nose jobs are safe. Yes, like all medical procedures, there is a possibility of complications or untoward effects, but they are very minimal. Infection rarely sets in. Loss of skin tissue is equally rare, regardless of what you may see on various websites. Millions of injections are done per year but only the ultra-rare complications get attention.
Non-surgical revision rhinoplasty costs are dependent on whether the permanent or temporary option is chosen. Typically, the permanent filler total cost is less than $5000.
The temporary cost may be $1000 or $1500 but by its nature, temporary fillers have a lease that expires and must be renewed six or 18 months later. Some lucky patients, and depending on the product, may not need a refill for two years. For the temporaries, one has to project such costs over the future.