So I just got back from one of our cosmetic society meetings in chicago and there are certainly alot of things to talk about. I did want to briefly address a topic that has been growing quit a bit. Non invasive nasal reconstruction is getting more and more popular. Using various fillers and botox/dysport we can alter the shape of the nose. Although it is certainly no replacement for nasal surgery, using these non invasive techniques certainly supplement the process. The simplest treatment is performing a slight lift in the nasal tip, which is a common complaint, with botox or dysport. By relaxing a muscle that pulls the nose down over time we can accomplish this. Unfortunately, it does take maintenance. Using fillers such as juvederm, restylane, and radiesse we can smooth out some bumps and reshape some asymetries that exist in the nasal structure. This is very common after nasal surgery where the result may not have been ideal. Nose job surgeries, like many cosmetic surgeries, are not perfect and 100 percent predictable. Instead of undertaking an additional surgical procedure, these non invasive alternatives can be very useful to acheive the desired result. For a permanent result, silicone microdroplets can be used once a temporary filler establishes a satisfactory result.
Although this is now commonly performed, it is essential to seek out a medical professional that has alot of experience with fillers. These are advanced techniques and they do have aesthetic and medical risks. So in summary, the advances in fillers and toxins really have enhanced rather than replaced the surgical means in changing nasal shape. Depending on the desired result there are instances that surgery can be avoided but this is not always the case. Consultation with both an expert in nasal surgery and a cosmetic dermatologist with expertise in fillers is necessary if considering these treatments.

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So i want to address an article that came out in one of the beauty magazines last month. It discussed the use of various fillers for the body as opposed to merely the face. I often get asked this question in my practice as it seems logical that if we can now sculpt and volumize the face that we can also accomplish this with the body. The fact is that it is possible but there are some logistical issues that often make it unrealistic. 1st off – most temporary fillers such as Restylane, Juvederm, Radiesse and Sculptra would be too expensive to use in significant volumes that would be needed for areas such as buttocks, breasts, hips etc. There are attempts being made with products such as Macrolane which is a hyaluronic acid fillers used in Europe for supposed breast enhancement. Unfortunately, its use is not very popular because it just does’nt compare to implants. You need to inject an enormous amount of it to get significant results and it is temporary. Implants are more consistent and natural appearing. There are certain instances such as body scars/defects and occasional deep cellulite pockets that I would perform body filling but it is not the norm. The most logical filler for body enhancement is one’s own fat. We certainly perform this in my practice. BUT…it is not common to find a patient who desires body fat transplatation to have enough donor fat from another area of the body. In addition, fat is not necessarily permanent either and would require several rounds of transfer to get enough fat to “stick” (this is true in the face as well). Fat transfer is most commonly asked about in reference to buttock enhancement…aka the brazilian butt lift. I do not perform this procedure because i have found in my own hands and also the results of many other physicians to be extremely inconsistent and often unattractive. The recovery is uncomfortable, the results often unnatural looking and most importantly too temporary to be worth the surgical procedure. There are some doctors that would disagree but most, including myself, believe that an implant is a more suitable option for buttock enhancement. So, pessimistic as it seems, i do believe that, as with all cosmetic technologies, we will see advancements in this arena. Although there are exception to the rule, i still believe that there are significant limitations in performing body volumization. I look forward to investigating, practicing, and writing about new options of treatment in the future.

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