A demonstration by Dr. Shervin Naderi of non-surgical rhinoplasty (liquid rhinoplasty) showing patient selection, injection technique, materials, limitations, and expected outcomes. He explains ideal candidates (low dorsum/bridge or mild dorsal humps with room above or below), cautions against inflammatory fillers (silicone, Bellafill, Artefill, Radiesse), and prefers Restylane (most patients) or Juvederm for thin-skinned patients. The procedure uses a microdroplet technique (radix, sidewalls, midline tip) with immediate visible improvement; expect maximal swelling the next morning and recovery in 2–3 days.
Chapters
Good morning. We're going to demonstrate a non surgical rhinoplasty injection. I've got plenty of them on the website. You can check them out. Different material, different patients, different anatomies. As I've said before, not everybody's a candidate for non surgical. The ideal candidate is somebody with a very low dorsum low bridge. You need to build it up, make it look more defined, more narrow, and give it some height. But there are varieties of patients that can be borderline candidates. For example, somebody who's got a dorsal thump or a little hump on the bridge. If there is room above it at the radix or there's room below it, you can create a straighter bridge and give it more of a natural contour. It's a matter of personal taste as well. Symmetry can also be increased. For example, if one of the upper lateral cartilages in this area is a little bit more pressed inwards. By injecting this area, you can create more symmetry. Nobody's perfectly symmetric, doesn't exist on the face, but you can create the illusion of more symmetry by doing that. However, there are certain changes that can't occur and certain things that you have to be aware of. It has to fit the person, has to fit the patient. For example, if you want to make the nose smaller, want to give it more of a curvature, want to make it more of a cutesy Barbie doll type nose, this isn't the way to go. This is more of a natural higher bridge. It doesn't burn any bridges. Literally what you can do later on, about a year later, if she wants to go with a different style of nose, you can go back to a surgical approach. However, you want to make sure you're avoiding things that are inflammatory. Don't put silicone, don't put belafil, don't put Arnafil, don't even put Radiesse into the nose because it's very inflammatory and can cause a significant scar tissue. But Restylane and Juvederm are saf. Juvederm is for very thin skinned patients. For most, they get Restylane. She's again on the border, but we're gonna go with Restylane. It's a microdroplet technique, lots of mobile injections. You'll see. I'm gonna inject the radix a little bit and the side walls to give it more symmetry and a little bit more natural look again, for some of you viewing, you may prefer a smaller nose. That's perfectly fine for her. She probably prefers that as well. But right now, at this juncture in time, a straighter nose is what she prefers. I'm gonna do this today. A little tiny poke. How bad was that? Not terrible. So the filler has additional numbing medicine in it called lidocaine. It's 0.3% lidocaine. So as we go, it gets better and better, little by little. Inject, assess. Now, the first couple days, it is more swollen. The next morning is actually your most swollen. So next day, you don't want to have any important meetings or events. But basically, two or three days from now, you should be fine. Any little bruises can be covered with makeup. And I can feel it already. Yeah, you're gonna feel that. You're gonna also feel some heaviness from the lidocaine medicine. This is a more sensitive area, but you're doing really well. I never like to put too much filler in one place and then have to massage it. I want to put the right amount of filler exactly where it needs to go. So we do a micro drop line technique. You okay? We're not done yet. But I want you to see from the front view. Bring your hand up. There's a mirror right in your hand. Take a look at the front, how much more symmetric it is. Yeah. Wow. See this area? So we're going a little bit more to the radix. It's above the bump. Now, there's a limit to how much you can put in here, because if you try to get rid of the bump completely by elevating the radix in some patients, you'll make them look like an avatar. And we've talked about this. We don't want to look like an avatar. We don't want to make the filler come off of the forehead just to cover a bump. So it depends on the starting position of the bump. It's already looking much better. Now, there's some candidates that are ideal candidates for this. I mean, they're gonna look much better non surgically than they would even surgically. Surgically. I think a lot of Asian patients fall in that category. And ideally, everything being equal, my favorite thing to do is to do a surgical approach to narrow nostrils. Surgical approach to create more projection to the tip. But there's nothing that's as nice as non surgical for the bridge when that's all you need. Because it's a soft material, there's no sharp edges. You don't have to worry about asymmetries as things heal. It's just a beautiful material. I'M going to put a little drop to the tip to get more projection. Right, you ready? And the tip, you want to stay right in the middle, a little bit more tender. You're staying right in the midline. It's important to be in the middle. You can get a little more projection so that it gives you more room for the filler of the bridge. If you drop the height of the camera and you can look at the profile, you can see how straighter it is here. So you have the bump. It's definitely straighter now. I can even come higher to make it even more straight, but then it'll be too high for here. So this is the limit that we reach. If the bump was a little bit small, it would be perfect. But again, this is a much improved nose than before. She doesn't have the bump anymore. It's perfectly straight here. I do prefer a smaller, shorter, more of a sloped nose on her, but this is a very nice alternative as well, until we get to the point that surgery becomes an option. And that's essentially it. And if we look at it actually from the top view, the camera comes up and takes a look at the top view, you can see much more symmetric. The indentation that was here, which was making the nose look crooked, is gone. And it looks so much straighter from that angle as well. This little redness and the purpleness that's basically from the injection, that'll be gone in a day or two. But you can put makeup on it and enjoy it immediately. And that's essentially it. That's a non surgical rhinoplasty.
