Permanent Non Surgical Nose Job Questions

Dear Dr. Rivkin,

Was wondering what your thoughts were on permanent fillers to the nose and aging. I believe the nose droops with age and that cartilage can still grow. How will this affect a permanent filler ?
Also is a permanent filler injected deep to the bone ? for example if one has a dent and the filler fills it up, is that filler fell like it's part of the underlying structure or more the skin ?
In addition ( sorry for all of the questions), how do you handle patients that come from other countries that can not come back in two weeks for a touch up ( post swelling)?
Thank you for your time


hi,
good questions.
1. i think that you are correct - the nose does change with age, but more slowly and subtly than the rest of the face. i try not to put too much filler in the tip - i do not want to increase the weight of it as the nose ages. but from the reports that i have read, artefill and aquamid both integrate well into the skin.
they should not become lumpy or irregular as tissues move with time. i don't get concerned with the bridge, since that area really does not move with time.
2. fillers for the nose should be injected just above the bone, but never deep to it. this way, the result is smooth and natural looking. filler (temporary or permanent) always feels like its part of the skin, not the bone or cartillage.
3. i ask them to make a mini vacation out of it - they see me at the begining when they arrive and then 5 days or 7 days later when they are leaving the country.
hope that helps