Rhinoplasty is one of the most popular cosmetic procedures in the country, with more than 300,000 performed in 2020 alone, according to the American Society of Plastic Surgeons. But if you ask anyone who’s considered getting a nose job why they’ve gone back and forth on the decision, it’s probably for a variety of reasons. The cost, extensive recovery times, permanence—the list goes on.
Enter “liquid” rhinoplasty, which uses fillers to contour the nose. We asked two experts on the topic—plastic surgeon Lara Devgan, MD, and cosmetic esthetician Nataa Elizondo, MD—to break down what you can expect when signing up for the procedure. Below, we thoroughly break down non-surgical rhinoplasty.
Meet the Expert
- Lara Devgan, MD, MPH, FACS, is a board-certified plastic surgeon based in New York City. She is the founder and CEO of Dr. Devgan Scientific Beauty and an attending plastic surgeon at several local hospitals.
- Natalia Elizondo, MD, is a cosmetic esthetician and general practice doctor in Sonora, Mexico.
What Is Liquid Rhinoplasty?
“Liquid” rhinoplasty, also known as non-surgical rhinoplasty, is a procedure that injects dermal filler (like hyaluronic acid) into the nose to alter its shape. “With a careful understanding of the three-dimensional surgical anatomy of the nose, I can use injectable filler as if it were a surgical cartilage graft to lift the tip, straighten the bridge, define the bulbousness, and improve the symmetry of the nose," Devgan says.
Devgan notes that although liquid rhinoplasty is one of the most instantly gratifying procedures, “it is also one of the most highly complex procedures in plastic surgery due to the intricate anatomy of the bone, cartilage, periosteum, perichondrium, subcutaneous fat, soft tissue, and skin of the nose.”
Benefits of Liquid Rhinoplasty
- Less expensive than surgical rhinoplasty
- Little to no downtime
- Instant gratification
- Not permanent
“In skilled hands, nonsurgical rhinoplasty can offer an extremely precise and minimal downtime way to improve the contour of the nose,” says Devgan.
Who Qualifies for Non-Surgical Rhinoplasty?
Devgan says patients looking to change bumps and droopy tips, rather than width, are ideal candidates for “liquid” rhinoplasty.
Conversely, Elizondo says that patients with too many nasal surgeries are not ideal candidates. “You have a hard time with patients who have had several nasal-related surgeries due to the filler being more difficult to inject," she explains. "I do not take patients [with] deep scarring; it wouldn’t be an ideal procedure.” Like Devgan, she notes that the weight of the tip of the nose is also crucial: A non-surgical procedure won’t do much if it’s too heavy. “The cartilage will begin to droop again, given that its weight outweighs the filler," she says.
How to Prepare for the Procedure
Devgan and Elizondo have similar approaches when conducting a non-surgical rhinoplasty. They have consultations before the procedure, making sure their patient is a solid candidate and that they can deliver the expected results. Elizondo mentions that if a patient isn’t suited for non-surgical rhinoplasty, she always recommends any available alternatives, such as referring them to a plastic surgeon if they’re comfortable going that route. Devgan is a board-certified certified plastic surgeon herself and lets her patients know if a surgical rhinoplasty will better meet their desires.
Before the procedure, the doctors recommend that you avoid taking aspirin or ibuprofen, as these may increase bleeding and bruising. It's also essential to stop drinking alcohol 24 hours before the procedure for the same reasons.
What to Expect During a Liquid Rhinoplasty
When starting the procedure, Devgan says, “I carefully analyze and assess their anatomy and mark and measure their nose and nose-chin balance, as a retruded chin is often corrected as part of a profile balancing.” Next, her nurse will take standardized photos, obtain informed consent, topically numb the face, and sterilize the impacted areas. “Finally, in performing a nonsurgical rhinoplasty, I use my signature approach: careful microdroplet injection technique, aspiration for safety, injection on needle withdrawal deep on the periosteum or perichondrium, and tip flip," she says.
Elizondo’s procedure is very similar, adding that in addition to the numbing cream, “I will add a cold gel to the nasal tip on some patients to numb the area further, as it can be the most painful for patients.” She also offers a stress ball, ensuring her patients take deep breaths and feel as comfortable as they can during the procedure. Then she carefully manipulates the filler to reach the desired shape, and after a few precise injections, she cleans the areas again to minimize the risk of infection. Finally, she adds bandages just as one would with a surgical rhinoplasty procedure so that the new nasal shape stays intact.
Before and after a liquid rhinoplasty performed by Devgan.
Before and after of a liquid rhinoplasty performed by Elizondo.
“Patients should avoid alcohol, aspirin, Advil, and blood thinners for several days before and after injectables," says Devgan. "Excessive movement or contact, including heavy glasses or sleeping on the face, should be avoided for one to two weeks." Exercise is not allowed, as it can increase the chances of an infection in the nasal area. The doctors also advise staying out of direct sunlight for those first few days.
Elizondo asks her patients to return after a week to 10 days for a post-procedure appointment to review progress and see if she needs to do a filler touch-up. “I also recommend my patients drink a lot of water," she shares. "The dermal filler I use is hyaluronic acid, a sugar molecule naturally produced by your body. Because it is naturally found in your skin and cartilage, not drinking enough water will cause your body to take the filler away from your nose over time.”
Regarding the longevity of the procedure, Devgan tells us that “the more times a non-surgical rhinoplasty is maintained, the longer it lasts, and after several sessions, some patients have results that last for years.” Elizondo tells her patients to come a year after their initial session for a touch-up. After a few more consistent corrections, she mentions that her patients can achieve a semi-permanent structure.
Liquid vs. Traditional Rhinoplasty
Devgan says that which procedure to get depends on the aesthetic and outcome you’re looking for. "[Liquid rhinoplasty] is not permanent and must be maintained over time, and it is not powered to remove tissue, alter breathing function, or reduce nasal width.” For these reasons, "patients with functional breathing problems, wide or severely over projected noses, or the desire to have a permanent solution are best suited for surgery.”
Elizondo echoes the same benefits and expectations. “This procedure is for cosmetic purposes only—its sole purpose is to harmonize the face using symmetry," she explains. "This procedure will not be able to fix conditions like a deviated septum or other conditions that affect breathing."
Both say the minimal downtime is a huge benefit of liquid rhinoplasties, considering a surgical procedure can take weeks to recover from and about 12-14 months to see full results.
A non-surgical nose job can cost anywhere from $700-$2,000, around 60 percent less than a traditional rhinoplasty.
The Final Takeaway
If you’re an ideal candidate looking for a less expensive, less invasive alternative to traditional rhinoplasty, liquid rhinoplasty has its benefits. But you must consult a medical professional to see if it's the right approach for you. “Many people don't understand the seriousness of nonsurgical rhinoplasty and injectables in general because they appear so quick and easy in Instagram videos and TikToks,” says Devgan. “The reality is that navigating the three-dimensional neurovascular anatomy of the face is like tap dancing through a stack of overlapping spider webs without breaking a single strand.”