A non-traditional approach to a bumpy nose

This is a terrific blog from the American Society for Dermatologic Surgery (ASDS) of which Drs. Barankin and Freiman are members. It highlights a regular occurrence we see and fix in our daily dermatology practice with very happy patients and safe natural-looking outcomes.

When Michelle came to my office, the reason for her visit was quite obvious. She was a beautiful woman with finely chiseled features. Yet, in the middle of her face she had a nose with a bump that strangely did not fit her pretty face at all.

She told me that she wanted to change the shape of her nose since she was 12, but in her adolescence she had been deterred from an operation. Now in her 20s, she was too busy with her career to spare time for recovery after surgery. Recently, she had learned about a non-surgical nose job and wanted to get a personal consultation.

“I have read that there is a new way to straighten a nose without an operation. How does this work?” Michelle asked me.

“The traditional way to achieve a straight-looking nose is to remove the bony bump with an operation,” I told her. “The new method instead focuses on filling the recesses next to the bump with soft-tissue fillers, and this also results in a straight nose. Although the nose is not decreased in size by an operation, it will be less noticeable and will seem smaller.”

“How can that be?” Michelle asked. “You fill the nose and it still seems smaller?”

“Well, an unconscious trait of our brain is to assess distances all the time,” I replied. “We instinctively perceive a straight line between two points as being shorter than a curved line. This is why an even nose seems to be smaller than a bumpy nose, though it may not be so in reality.”

Michelle asked me to explain in detail how it works.

“Actually, this is more a question of the experience and knowledge we dermatologic surgeons acquire in our training,” I told her. “When you come in, we analyze all of your facial features to ensure that the treatment result will fit your face. We consider the form of your forehead and of your cheeks. Also, the height of your lips and the size of your chin are taken into account. Sometimes the straightening of the nose is combined with a lifting of the nose tip or a lengthening of the upper lip. To an extent, this can be accomplished with hyaluronic fillers.”

In our practice, we use an absorbable filler like Juvederm Voluma hyaluronic gel. This is a safe, well-tested filler that usually lasts nine to 12 months. The non-surgical nose job usually takes 20 to 30 minutes and should be performed by a dermatologic surgeon in a hygienic clinical setting. Dermatologic surgeons are trained in facial anatomy, which is crucial in an area with many blood vessels and nerves. We also are experienced in using dermal fillers and are in the forefront of developing new applications.

Michelle smiled. “So you are a dermatologic surgeon and prefer a non-surgical treatment?”

“Yes,” I said. “In many instances, this non-surgical nose job is a very good treatment option. And though it may seem a little odd, every surgeon’s aim actually should be to avoid an operation if there is better option.”

“Thank you so much,” Michelle said. “I will see you soon, doctor.”

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