Rhinoplasty, or nose jobs, continue to be one of the most-performed surgeries globally. Last year, top cosmetic clinic, The Cadogan Clinic, saw a 90% rise in surgical and non-surgical rhinoplasty procedures. And following lockdown, enquiries into rhinoplasties have risen another 20% with many patients citing “zoom-face” as a motivation.
The main concern for patients, according to research conducted by Mr Duncan Atherton, aesthetic plastic and reconstructive surgeon at the Cadogan Clinic, is correcting their dorsal hump (a bump on the nose made from cartilage and bone). He's had patients reference everyone from Rihanna to Meghan Markle and even the Marlboro Man Cowboy as the "perfect" shape.
However, rather than going under the knife (which is a more gruelling, permanent procedure that requires 10-14 days recovery), this is one of the easiest problems to correct with non-surgical rhinoplasty – a non-permanent procedure that can be done in 10 minutes with no downtime.
“The nose is a 3D complex structure composed of skin, soft tissue, cartilage and bone," explains Mr Hazim Sadideen, a consultant plastic, reconstructive and aesthetic surgeon, who performs both surgical and non-surgical rhinoplasties. "Much of what you see is to do with the shadows. Some contours are more prominent in certain lighting or angles, and a non-surgical treatment is a great way to soften this.”
We asked Mr Sadideen to run through everything you'd need to know about non-surgical rhinoplasty's: how they work and what's achievable.
What is a non-surgical nose job?
A non-surgical nose job uses filler to reshape the contours of the nose. It's done in a doctor's chair while you're awake and involved local rather than general aesthetic. "A non-surgical rhinoplasty generally uses hyaluronic acid dermal filler to make small adjustments to change the shape of the nose," says Mr Sadideen. "Most commonly it can be used to camouflage dorsal humps (including larger 'bumps'), raise the nasal tip, making it look more defined and improve certain contours."
How long does the procedure take?
"The procedure takes around 10 minutes to perform with minimal pain and no real downtime; patients can go straight back to work with little tell-tale signs other than a very small chance of a tiny bruise or little swelling," says Mr Sadideen.
What does the procedure involve?
Your practitioner will sterilise your nose and the area around it with an antiseptic liquid before applying a small amount of anaesthetic to numb the skin (this feels like a sharp scratch and is considered by many to be the most painful part of the whole procedure). Once it's been confirmed that you can't feel anything, the filler will be injected in small amounts, just where it's needed, into the precise contours of your nose gradually to allow the practitioner to step back and ensure the shape is uniform. Then, the filler is massaged and moulded gently to ensure it's smooth and even.
How quickly will I see results?
"Results are visible immediately after the treatment and will be fully evident in 2-3 weeks to allow any minor swelling to settle," he says.
How long will the results last?
"Non-surgical rhinoplasties are not permanent, they last between 9-18 months depending on the nasal anatomy and skin thickness. Interestingly, however, this does not mean that the procedure needs to be repeated every 9-18 months as there is often good retention in shape; some patients return for their top-up at 2 years, and have required less filler at this stage," says Mr Sadideen. "Thinner skin requires a thinner viscosity dermal filler and will initially likely last for a shorter period of time whereas thicker skin can tolerate a thicker filler with longer lasting results from 12-18 months. 2-3 treatments may be required to build up gradually and achieve the optimum results especially in cases where thinner filler is used."
What is the benefit of a non-surgical nose job over a surgical nose job?
Surgical rhinoplasty's give you the ability to make more drastic changes. Both surgical and non-surgical procedures can improve symmetry, reduce bumps and reshape the tip, however non-surgical procedures are more limited within the confines of your existing shape. They can reduce the appearance of bumps, but they can't remove them or reduce the size of your nose altogether. Surgical procedures can alter the size and shape of your nose, reshape the nostrils, improve breathing difficulties (and snoring) and repair injuries.
That said, surgical nose jobs are more painful, involve more risks and a much longer recovery time. They're permanent which means you won't need to repeat the procedure every few years, but you can't always guarantee you're going to like the results. Non-surgical nose jobs can achieve a very similar result with less risk, fewer side effects and no downtime. They're also non-permanent (and reversible if very necessary). "Some patients adopt a 'try before you buy' approach where they opt for a non-surgical treatment before committing to the permanent surgical solution," explains Mr Sadideen. By undertaking a thorough assessment, surgeons will be able to guide patients as to whether a non-surgical or surgical rhinoplasty is more appropriate. It's important to discuss your requirements in detail with your practitioner and have realistic expectations of what is achievable.
What happens if I don’t like my results?
"If the patient is unhappy with the non-surgical results, the dermal filler can be dissolved with hyaluronidase injections but this is not encouraged unless it is necessary," says Mr Sadideen. "It is also very important to see a specialist in this procedure in order to minimise the risk of complications."
What's the aftercare like?
"Simple, minimum maintenance is required following a non-surgical rhinoplasty," says Mr Sadideen. "In addition to the general advice with hyaluronic acid fillers (e.g. keeping the area clean, avoiding make-up to the area for 24 hours), Mr Sadideen advises you to avoid exercising for 48 hours after treatment, refrain from wearing heavy glasses, avoid sun exposure and heat (e.g. sauna and hot yoga) for 2 weeks post procedure, avoid moving the area or applying pressure and avoiding contact sport or exercise where there is a risk of the nose being knocked.
What are the risks involved?
Dermal Fillers are extremely safe when delivered by a trained medical practitioner. That said, whilst extremely rare when fillers are delivered in a medical environment by a medical professional, possible risks include, asymmetry or uneven results, allergic reactions, bruising, bleeding or swelling at the injection site, damage to skin and possible scarring, lumps of filler under the skin, skin necrosis and infection. That's why it's very important to make sure you choose a practitioner who's very experienced and qualified.
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How to choose a rhinoplasty surgeon?
Whether you're opting for a surgical or non-surgical rhinoplasty, it's important to do your research. Not only do you need to ensure that your doctor able to carry out the treatment, you want to ensure they have the expertise to make corrections or address any problems should anything goes wrong. Make sure you look at before and after pictures of their previous work, read patient testimonials (if you can get a recommendation from a trusted friend, that's even better). Check out their qualifications and which organisations they belong to (membership of BAAPS, BAPRAS and Rhinoplasty Society of Europe are recommended). Make sure the clinic you go to has a reputable track record for safety and hygiene.
How much does it cost?
Costs vary considerably depending on where in the country you are, the anatomy of your nose and the work involved, the amount of filler used and the type of filler used, but treatments at The Cadogan Clinic typically start from £450.
