In an aesthetic vision of the face, the nose shape is crucial, therefore, its corrections are an indispensable part of the global facial cosmetic correction itself.
Until recently, the only way to bring an improvement to the imperfections of the nose was the surgical approach: first the traditional one, then the most conservative and recently a minimally invasive approach. Only in recent times are we performing a medical, minimally invasive correction of the nose’s imperfections, with fillers. There is a substantial difference between the nature of surgical treatments and those of a medical one. The surgical approach consists of the demolition and reconstruction of the nose or any of its parts, while the medical approach is considerably more conservative and used when it is necessary to fill depressed areas of the nose, bringing them back up to the same plan of the most prominent parts, without increasing the volume of the nose itself.
Each type of approach requires a thorough understanding of the nasal structures. It is necessary to know that the nose is composed of a bony and a cartilaginous part, covered by very thin muscles.
Any intervention on the nose should take into account the aesthetic canons of facial balance: the length, the height and the average depth, relatively different in man and woman, as well as the projections of the nasal profile in proportion with the nearing structures, such as the forehead, eyes, cheeks, lips and chin. Paramount is the detailed knowledge of the skin thickness in different areas of the nose, where the filler is set, in order to be able to bring the desired corrections.
When do we need filler treatments ?
Alterations may be required because of the bones shapes: too small, triangular, rudimentary and not connected to the frontal bones, with varying widths or missing altogether.
In addition, alterations of the nasal profile can be congenital: congenital growth hormone deficiency for which the root of the nose is sunken; of traumatic nature: after fractures or contusions of the bones and/or cartilage; post surgical nature as a result of interventions carried out for structural or functional problems or for aesthetic purposes.
Alterations of the size of the nose, determines the choice of subsequent surgical or medical treatments. Therefore, a long or big nose or a wide nose may require surgery, while the medical treatments with fillers may be required with short, narrower, or small noses.
Alterations may concern correction to its many shapes: hooked, droopy, Aquiline, upturned, button, diverted, snub, funnel, the ethnic nose, etc.
Correction with fillers
Corrections with filler may cover any part of the nose: the back, the tip, the root, one or more portions simultaneously. Personally, I prefer to use long lasting material in particular for corrections to the bone profile. Best product for these cases is calcium hydroxyapatite, while for the correction of soft parts I prefer to use hyaluronic acid of various density and viscosity according to the patient’s skin type. In experienced hands, the treatment takes a few minutes.
Treatment pain and bleeding will be prevented through detailed anatomical knowledge.
I am often asked to fill the root of the nose which, in some subjects, is very deep set and requires significant amounts of calcium hydroxyapatite.
Corrections of the soft parts, ie close to the cartilage, may require one or more sessions.
Improvements are immediate. The modelling of the treated parts is followed by a moderate compression of a few minutes, and the application of antiseptic ointments within post-treatment guidelines (eg. avoid exposure to low and high temperature, UVA, contact physical activities, intake of specific medications, etc.).
In conclusion it is clear that the treatment of rinofilling is effective and long lasting, it does not require any post treatment downtime and it allows immediate recovery. Furthermore the costs of the treatment is contained and the level of patient satisfaction is high.