Various filler materials exist, and are catered to cosmetic outcome, as well as patient goals for longevity. Filler material can broadly be separated into permanent and temporary, however most various types exist on a spectrum from months to years. Juvaderm is temporary filler with multiple formulations that vary in thickness, best suited for certain locations on the face respectively. Other more long lasting filler materials include fat from our own bodies, poly-L-lactic acid (also known as Sculptra), and Calcium hydroxyapatite (also known as Radiesse).
As part of a growing trend towards noninvasive procedures with less pain and recovery time, methods to address cosmesis of the nose have emerged. Other names include “nonsurgical rhinoplasty” and “liquid rhinoplasty”. Generally, filler material is carefully injected into certain areas of the nose in order to change the projection, angulation, smoothness, or correct certain defects.
Other methods such as the “thread lift” include the use of suture material that can provide a scaffold to reshape the nose. Popular choices include Polydioxanone (PDO) threads. Additionally, there are nasal implants, such as the Latera implant, that support the nasal cartilage and increase the diameter of the nasal valves through which we inhale, for patients interested in functional rather than cosmetic outcomes.
Nasal deformity requiring rhinoplasty, or “nose job”, is typically divided into two broad categories. Functional rhinoplasty aims to improve breathing, while cosmetic rhinoplasty is geared towards improving the perceived structure of the nose. Many characteristics and measurements determine the outward appearance of the nose.
Classically, certain angle measurements and ratios have been described for the male and female noses. Rhinoplasty is an umbrella procedure that may entail the use of creative suturing, or removing and restructuring components of the nose using grafts, cartilage, implants, and injectable filler.
Juvederm is made of Hyaluronic acid, which is a compound naturally produced by human skin. A main benefit of Juvederm is that misplaced filler or migrated filler can be broken down with the use of hyaluronidase, which is injected into areas where breakdown is preferred. There are many formulations of Juvederm, such as Voluma XC (popular in cheekbone injections), Volbella (popular as a lip filler), Ultra XC (lips and perioral area), Juvederm XC and Vollure XC (Facial wrinkles and nasolabial folds). These formulations vary in thickness and viscosity.
Depending on the patients skin thickness and nasal deformity, many of these may be used to address the nose. Popular techniques include injecting material along the dorsum of the nose in order to achieve a smoother contour, along the sidewalls to increase nasal width, and along the anterior most dorsum in order to create the perception of a narrower nose. Injecting near the tip of the nose is described, however it may place patients at risk of injection into an artery that supplies the nose, which can cause serious complications such as blindness and skin death. Juvederm lasts for between ½ to 1 year.