The no-op nose job

Cape Town - Many turn their noses up at the thought of a surgical rhinoplasty. But increasingly, people are opting for a surgery-free nose job.

It may not be a permanent solution, but it’s not invasive. There is no “chisel and hammer”. The procedure can take about 10 minutes, and afterwards there are no bruised eyes or bandages.

At present, surgeons replace the 'wings' with cartilage grafts taken from the ear.Anterior After - Photo: Dr Alek NikolekLeft Profile After - Photo: Dr Alek NikolekA patient from the front before. Photo: Dr Alek NikolekLeft Profile Before - Photo: Dr Alek NikolekDr Alek Nikolic, aesthetic medical practitioner

In the non-surgical procedure, a dermal filler is injected just above the nasal bone and cartilage to allow for reshaping and correction of nasal defects.

Cape Town aesthetic medical practitioner (different from a plastic surgeon) Dr Alek Nikolic says the filler rhinoplasty has been around for a long time, but has only really taken off as an alternative to surgery in the past five years.

The procedure involves the injection of hyaluronic acid-based fillers into the nose to create a new shape. Nikolic warns it does have its limitations. Bigger noses can’t be made smaller and the filler lasts for only 12 to 18 months.

Often, Nikolic sees patients wanting to correct previous operations. A case in point is a woman in her forties, who had two rhinoplasties. The first was to correct a few defects and reshape her nose. The woman needed a second operation to produce the result she originally wanted.

But after the second procedure, she developed a bacterial infection which destroyed nasal and cartilaginous tissue. Nikolic says her nose was left deformed, and as a result it interfered with her day-to-day life.

The infection had destroyed her nose and her confidence.

Nikolic explains that with surgical rhinoplasty, it takes several months for the nose to heal. Unless there’s an infection – which will be treated immediately – doctors wait between six months and a year before they will operate again.

When it comes to the nose, even a 2mm deviation is noticeable and can affect the balance of a face, says Nikolic.

The filler used on the nose is thicker than similar products used in the lips and has the ability to support the nasal tissue and look natural, he says.

If patients are unhappy with the result, they can have the filler dissolved immediately and revert to the old shape.

He says the procedure will cause pain and discomfort, but it won’t be unbearable. The tip is the most sensitive part of the nose, but this is rarely injected.

The global debate about beauty has been raging for a number of years, as many aspire to Western ideals.

These include smaller noses, bigger eyes and straight hair.

Dr Julie Sinclair, a Joburg aesthetic medical practitioner, has seen an increase in patients of various races who want subtle results.

One of her 28-year-old patients had a wide nose and flat nasal bridge, and was unhappy with the shape. She was injected on each side of her nose, causing her bridge to appear raised.

“A flat bridge can be corrected by a slight increase in height, and you can balance the size of the nose so that it looks more appropriate with other facial features,” says Sinclair.

Surgery trends suited to skin tone

Joburg aesthetic medical practitioner Dr Alek Nikolic says black skin is relatively thick and can withstand a lot of movement.

Fine lines and wrinkles become an issue only later. But black men and women tend to lose volume in the middle face. In this market, there is a demand for filler in the cheek area.

White men and women wrinkle more than people of other races but tend to keep volume.

Asian clients tend to have prominent jawlines and facial muscles.

This segment of the market generally opt to have their faces recontoured by softening the jawline.

Indians age in a similar way to white people but Indian men age faster. For this reason more Indian men are using fillers, Nikolic says.

McDreamy and other star snouts under the scalpel

For many Hollywood stars, their noses were top of their list of things to nip and tuck.

Perhaps the best-known case of one too many nose jobs was Michael Jackson. He is thought to have had six nose ops.

As his skin grew lighter – due to the vitiligo illness, Jackson maintained – his nose became smaller and thinner. It was speculated that he’d lost the tip of his nose, and used a prosthetic tip.

Other celebs who have been under the surgeon’s knife to change their noses include Patrick Dempsey, Jennifer Aniston, Beyonce and Kelly Rowland.

Closer to home, diva Khanyi Mbau wrote a testimonial for a beauty website, saying she had tried the filler rhinoplasty, and had used filler in her cheeks to add volume. - Esther Lewis, Cape Argus