The author discusses a personal perspective, and preferred treatment techniques of non-surgical rhinoplasty, using dermal fillers and botulinum toxin. Onabotulinum toxin A and incobotulinum A are discussed for off-label use in this advanced indication, and the author suggests using calcium hydroxylapatite once a patient has received hyaluronic acid on three separate occasions, to ensure that the patient is comfortable with the process and outcome from dermal filler injection. Whilst emphasis is placed on a thorough consultation, it may have been useful for the reader to have been provided with discussion surrounding unsuitable or complex presentations, for example, patients who have previously undergone surgical rhinoplasty owing to the increased risk of complication through altered anatomy. The author discusses a preferred choice of needle instead of a cannula approach when augmenting the dorsum of the nose with dermal filler, owing to the ability to perform an aspiration before injection. It is prudent for the reader to remain aware that needle aspiration prior to dermal filler placement has not been robustly proven to prevent vascular compromise, with recent literature to support this. A comprehensive overview of nasal tip augmentation, bunny lines and correction of nasal flaring is provided, as well as correction of dimples, dents and depressions. A thorough description of venous and vascular complications is provided; yet, the author stressed reliance upon aspiration as a definitive method to prevent vascular events, which has not been definitively proven. This article was previously published in 2014, in the Journal of Aesthetic Nursing, but has the useful addition of two independent clinician perspectives on non-surgical rhinoplasty, sharing their experience of the procedure and advising caution surrounding the expertise and required skill level to undertake successful treatment, in spite of reported marketing strategies as a ‘quick-fix’ treatment.

Non-surgical rhinoplasty: key indications and considerations for nasal augmentation.
Zarb Adami R.
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Anna Baker

BJN Aesthetic Nurse of the Year 2016.

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