Treatments today are increasingly being tailored to the particular needs of various ethnic groups. Los Angeles has a large Asian population and responding to their particular aesthetic concerns has become important to many cosmetic practices here. One of the more common reasons that Asians come in, is because they are unhappy with their nose. Most do not want a Caucasian nose. They want to have a higher, better-defined bridge, but they do not want to go through surgery. Some just do not have the time to go through the healing process, some are afraid of the risks involved, some can’t afford the expense, and some are afraid of ending up with unnatural results.

Typically, the Asian nose has a lower, flatter and less defined nasal bridge than the Caucasian counterpart, with a rounder tip and wider spaced nostrils. Of course, there is wide variation among the different peoples of Asia and among different individuals. Also, standards of beauty differ. It is the job of the cosmetic specialist to understand the aesthetic result that the patient is looking for and to communicate the medically feasible possibilities. The patient then decides what should be done and the practitioner delivers the procedure with maximal precision and minimal risk.

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The traditional mindset is that an operation is the only way to correct cosmetic nasal irregularities, even the most minor bumps or asymmetries. Over the last five years, that concept has been shown to be no longer true. Injectable fillers have been used for the last five years (I prefer Radiesse – a calcium based temporary filler that lasts about 10 to 12 months and holds its shape very well) to raise the nasal bridge and make the tip higher and less round. This procedure has been called the Non Surgical Nose Job or Non Surgical Rhinoplasty.

Non-surgical cosmetic improvement of the nose only became possible recently as new fillers became approved by the FDA. Radiesse and its cousins Juvederm and Restylane are safe, natural looking and relatively long lasting. Over the last five years, as injectable fillers have been used as an effective alternative to rhinoplasty, the Non-Surgical Nose Job has demonstrated itself to be a procedure that is safe and effective with significantly less discomfort and risk than traditional rhinoplasty.

Non-Surgical Rhinoplasty is a relatively painless procedure that requires minimal downtime and post-procedure care. Many patients resume normal activities immediately after their injections, returning to work or a busy social calendar on the same day as the appointment. Slight bruising or swelling may occur at the site of injection, however the severity of the inflammation pales in comparison to the aftermath of traditional rhinoplasty. If discoloration or tenderness does occur, it usually disappears within a few days. The procedure is usually performed in a couple of sessions so that the changes are gradual. There is never a sudden transformation – no “Aha! You had your nose done!” moments.

Topical anesthesia is adequate for pain control, and icing the nasal area just before injection reduces the chances of bruising. Patients should take Arnica Montana orally after their injection – it works well for reducing any swelling or bruising that may follow. Patients can use Tylenol, but should not use non-steroidal anti inflammatory medications (Advil, Alleve, etc) for 3 days or wear sunglasses for 2 weeks after the procedure. No other limitations are required. The Non-Surgical Nose Job usually takes between 10-15 minutes to perform. Patients are usually in the office for about an hour, however, when we figure in the time needed for topical numbing cream.

This procedure is certainly no replacement for surgery. It cannot reduce the size of a nose, but most of my Asian clientele don’t need reduction. They want to preserve the ethnic appearance of their nose, but are looking for more symmetry in their facial features. Some have said that they would like to have their glasses resting on their nasal bridge as opposed to their cheeks.

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As with any medical procedure, selecting the right physician to perform the Non-Surgical Rhinoplasty procedure is critical. Injecting filler into the nose must be done with care and a thorough understanding of both nasal anatomy and the properties of the filler being used. A patient contemplating this procedure should make sure his or her physician has had specific training and experience in cosmetic injection techniques, especially if the doctor is not a formally trained aesthetic surgeon. Precise knowledge about the injection spots, depth, and amount of filler needed is very important for the success of the procedure.

Changing one’s appearance is becoming more accepted as the procedures are becoming cheaper, safer and easier. Media coverage of plastic surgery is also making the people who get these procedures seem less stigmatized and more mainstream. The patient must still exercise extreme care in choosing the right practitioner, but it is heartening to see innovative procedures emerge from new technology. For my Asian clientele, Non Surgical Rhinoplasty represents an alternative to surgery that is safer, easier, cheaper and sometimes more effective. It is a natural looking way to achieve the desired changes without “whitewashing” the client’s ethnic appearance.

Alexander Rivkin M.D. is a Yale trained facial cosmetic surgeon and UCLA faculty member who has focused his practice exclusively on providing his patients with the latest in non-invasive, non-ablative cosmetic treatments. Dr. Rivkin is an international authority on non surgical cosmetic treatments. He divides his time between patient care, clinical research, educating other physicians, media appearances, and lecturing at scientific conferences throughout the world. Dr. Rivkin has made his name in developing non-surgical alternatives to commonly performed cosmetic procedures. He has been featured on the shows like the TODAY show, the Tyra Banks Show and EXTRA as well as in numerous national publications for the innovative procedures he has invented. He was the first physician in the country to offer the Non-Surgical Nose Job, his signature method for non-invasive correction of cosmetic nasal irregularities.

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