Plastic surgery experts long ago concluded that a first rhinoplasty is mishandled in about 20 percent of cases, leaving patients still unhappy about the look of their noses. It’s not so much a case of fumble-thumb doctors, but a very, very difficult procedure –rhinoplasty — that takes, even in the best of hands, years to understand and even longer to master. Usually, an unsatisfying result causes once-burned patients to become research experts searching for a more experienced cosmetic plastic surgeon or even perhaps one who is a nose job “superspecialist”.
Here’s the surgical low-down on nose job re-dos:
Typically, a first rhinoplasty has resulted in grooves, moguls and depressions on the outside of the nose, visible to all who can see. Most times, too much bone and cartilage have been taken from the nose. What has happened? The very deft touch and extensive knowledge of nasal anatomy required for taking out just the right amount of nose tissue has not quite settled in on the first surgeon. Not only must that first cosmetic surgeon have a feel for the “right amount” of tissue to remove, he or she must see through the complete healing of dozens — if not hundreds — of such noses. But the patient only cares that the first nose job left the nose looking pinched or too scooped out. Ah, but what to do?
A second, or revision, surgery means:
- More time away from the job and family
- Another expensive procedure
- Yet more downtime for healing
- Other inconveniences including some post-op discomfort
But there is another way: nose filler injections. One particular patient was a case in point. Previously, she had multiple surgeries on her nose to correct the damage done on her first rhinoplasty. She was really down in the mouth about having yet another surgery but was extremely unhappy with her nose’s look. But when learned of another way to achieve a permanent revision without surgery, she became so overwhelmed by relief, she shed tears of joy in the consultation room.
How are the changes affected with only syringes?
Droplets of liquid silicone, injected just under the skin of the nose with ultra-fine needles – about the width of four human hairs – can work magic for repairing nose irregularities. More good news: no need to hide afterwards. The injection procedure involves no bruising, swelling or facial discoloration. After the injections, you go back to whatever you were doing before the appointment. Many patients have not heard to using silicone droplets to repair bad places on the nose.
- Silicone in breast implants have been proven to be safe
- Silicone drops are FDA cleared for use inside the eye, an even more critical and delicate area
- Solid silicone is used for FDA-cleared artificial joints and heart valves
- Just about everybody has been exposed to liquid silicone
Hypodermic needles used to take blood samples or give other injections are coated with silicone drops to make puncturing the skin easier and less painful. Cosmetic plastic surgeons are allowed to use the drops under a concept known as “off-label”. That means a device or substance – silicone drops in this case – is used for a purpose not intended by the manufacturer.
But in the physician’s best judgement, it’s the best choice because it has worked well for his other patients. Additionally, it does not take much to get great results. About 25 percent of a teaspoon does the job. Other popular fillers – like Restylane, Juvederm and collagen — only last six months, after which they are absorbed by the body. A good place to read about the non-surgical nose job procedures is Singapore Beauty Secrets. The non-surgical nose job with filler injection is temporary, those injections need to be repeated. But silicone drops are permanent.
Nonetheless, most revision rhinoplasty patients are only offered additional, expensive complex surgical session in the operating room. Nonetheless, the final results of yet more bone or cartilage tissue grafts are unpredictable at best. But some cases cannot avoid surgery. The nose’s chief job is breathing; if a nasal blockage prevents the normal passage of air, there’s no choice except surgery. Some patients find the concept of the injection treatment hard to swallow, even when shown before and after rhinoplasty revision pictures.
So they are offered a test drive. The patient is given:
- A mirror
- An injection of sterile, salt water into the dents, moguls and other nose defects
While the salt water dissipates in an hour, the saline does its job and briefly creates a more pleasing nasal appearance. Before and after pictures are taken during the test drive and e-mailed to the patient so it can be mulled over with the family.
You won’t find many rhinoplasty revision doctors offering revision rhinoplasty via silicone drops. But if you do, be sure and ask:
- How long have you performed this technique?
- May I see one of your patients who had a similar problem fixed by liquid silicone?
- Do you still have before and after pictures of salt water “test drives”?