Ventura's 15-minute Nose Job

Hi, Dr. Pickart,

Have a quick question.  Do you do non-surgical nose jobs?  I researched it, and I heard that it involves using injectables such as Botox or Radiesse to shape and to contour the nose.  I am very interested!!!  :)

Sincerely,

Britney

Dear Britney,

I absolutely do non-surgical nose jobs!  I can customize an approach that...

• We can complete in 15 minutes in my office.
• No IV.
• No incisions.
• No stitches.
• No time off work.
• No general anesthesia.
• Just injectables under local anesthesia (like novocaine).
• Except for mild swelling and bruising, you'll be back to normal (albeit with a cuter nose) as soon as you walk out of the office.

Here are the 3 options for a non-surgical nose job:

Botox:

• Botox is a muscle relaxant.  It works by relaxing muscles that cause wrinkles or that distort anatomy.
• Botox is, by far, the most popular non-surgical treatment in the USA and in my office.
• At the nose, Botox is good for dynamic depression of the nasal tip.
• Translation:  When some people smile or frown, they activate muscles in the middle, upper area of their upper lips.  These muscles not only raise their central upper lip (with its bow), but also pull down the tip of the nose.
• Some people who have this anatomy, like it; they think that a dynamically droopy nasal tip is cute.  Other people with this anatomy hate it.
• If you had this anatomy and you disliked it, then I would use Botox to relax the offending muscle.
• Cost:  about $40-50 per treatment.
• Duration of the effect:  3-4 months.
• Therefore, cost per year:  $120-200.

Juvederm/Restylane:

• These products are technically known as hyaluronic acids (HAs).  HAs are natural substances, found in skin, bones, joints, etc.  Elsewhere in medicine, they are commonly used by orthopaedic surgeons to minimize pain in knee arthritis.
• How do they work in plastic surgery?  HAs are clear jellies that function like chemical sponges.  They get bigger by holding in water.  They are used to plump up tissues that are deflated, to fill in folds or wrinkles that are caused by a loss of baby fat or bone, to correct "caved-in" deformities from injuries, etc.
• Juvederm and Restylane are very similar products.  I tend to favor Juvederm, because it is softer than Restylane.  However, both are excellent.
• Both HAs are relatively soft and easy to mold.  It can help to reshape a nose, especially if...
  • there is a depression from a previous injury (to fill in the concavity thereby smoothing the nasal contour)
  • the patient has a flat nose without adequate projection (to augment a nasal tip)
  • the goal is to augment a nasal bridge (such as when a patient's nose projects normally but when thee bridge is low, giving the false impression of a nasal hump)
• Juvederm and Restylane are extremely safe.  I have never heard of an allergy.  None of my patients have ever had an infection.
• Also, both Juvederm and Restylane have an antidote.  If you hate the look of the non-surgical nose job, then you can just dissolve the HA away!  Nearly foolproof!
• Cost:  $450-500 per syringe.  One syringe is usually enough.
• Duration of the effect:  6-12 months.

Radiesse:

• Radiesse is technically known as calcium hydroxylapatite.  It is a calcium-based putty.  Similar products have been used by orthopaedic surgeons to help with the healing of broken bones and by ENT doctors to help with paralyzed vocal cords.
• How does it work in plastic surgery?  Very similar to the hyaluronic acids.  The putty fills in tissues that have deflated, folds that have become deeper, concavities from trauma, etc.
• I like Radiesse when an augmentation needs to be a bit stouter.  Radiesse is a thicker, bulkier product than Juvederm and Restylane.  It tends not to mold quite as well as the HAs, but it can provide a firmer, more durable correction.
• So, a patient with thicker skin may be a better candidate for Radiesse than an HA.  Young men have thicker skin, so I tend to use Radiesse in this group; however, older women have thinner skin, so, for them, I tend to recommend the HAs.
• One area of thick tissue on most faces is the chin.  Radiesse is my preferred product for a non-surgical chin augmentation.  Frequently, increasing the prominence of the chin makes the nose look smaller.  In effect, enlarging the chin balances the face so that the nose no longer looks disproportionately big.
• Radiesse is extremely safe.  No allergies.  No infections.
• But no antidote.  You have to be sure of this one!
• Cost:  $750 per full-size syringe.  For a focal area, a small syringe costs just $375.
• Duration of the effect:  8-16 months.  (I used to think that Radiesse would last 12-18 months, but this was probably an overestimate.)

 
Britney, you and I should really talk about your goals, before we jump into anything.  The goal is to customize the right product for you!!
 
Sincerely,
Mike Pickart

P.S. Thank you for recent referrals for breast surgery.  Glad that your breast augmentation went so well!!

Comments

[athena]

Dear doctor:
i want to do an non-surgical nose job. Could you show me the price?
Please email me if possible .Thank you.
Mil

[Susan]

Hi I had a quick question about the non-surgical nose job. I heard after the injection goes away you are left with lose skin or wrinkles. is that true?

sincerely,
Susan

[Michael Pickart]

Dear Susan,

Not true! The skin of the nose is tight and elastic. It snaps back when the filler dissipates.

(Don't be confused by what happens to breasts. Breast skin does become loose after volume loss. Ask any woman who has been pregnant; after the cessation of breast feeding, the breasts lose their larger size and can then become droopy.)

Sincerely,
Mike Pickart

[Foqia]

I love it. Thanks for the information.

[Nose job ny]

Well answered Dr. Pickart and thank you for sharing your answer to her question for some of your readers are curious about this matter as well.

More power!
Brian

[Michael Pickart]

Glad that you appreciated the article!

Michael C. Pickart, M.D., F.A.C.S.
Pickart Plastic Surgery, Inc.

428 Poli St.,#2C, Ventura, CA 93001
(805) 648-4567 | fax (805) 641-0811

To: info@pickartplasticsurgery.com