Eye Lash Hair Transplant Surgery - Procedure

www.drvaibhavshah.net

 +Dr Vaibhav Shah

+Dr Vaibhav Shah

Eyebrows and eyelashes make an important contribution to facial symmetry and presentation of self to others. A person without eyebrows and/or eyelashes may feel very self-conscious about his/her appearance. Transplantation or reconstructive surgery can often restore eyebrows and eyelashes.

Eyebrows and eyelashes are lost in a variety of ways:

·         Physical trauma—e.g., auto accident, thermal, chemical or electrical burns

·         Systemic or local disease that causes loss of eyebrow and/or eyelashes

·         Congenital inability to grow eyebrows and/or eyelashes

·         Plucking (to reshape the eyebrow) that results in permanent loss of eyebrows

·         Self-inflicted obsessive plucking or eyebrows and/or eyelashes (trichotillomania)

·         Medical or surgical treatments that result in eyebrow or eyelash loss—e.g., radiation therapy, chemotherapy, surgical removal of tumor.

The cause of eyebrow/eyelash loss is evaluated in medical history and examination prior to consideration of hair restoration:

·         Systemic or local disease that causes hair loss must be under control to assure that hair restoration can succeed

·         Obsessive-compulsive plucking (trichotillomania) must be treated to assure that restored hair will not be plucked out

·         Trauma, burns or surgery may have resulted in formation of scar tissue; reconstructive surgery may be necessary before eyebrow/eyelash restoration. The degree of eyebrow loss may vary from complete to partial; the degree of loss may be a consideration in selection of the restoration procedure.

Some patients have no eyebrow/eyelash loss, but seek eyebrow/ eyelash enhancement for cosmetic reasons such as a change in the shape of an eyebrow or longer eyelashes.

Eyebrow Hair Restoration

A number of procedures are available for restoration of all or part of the eyebrow:

Transplantation of follicular units or single hairs from a donor area to the eyebrow, and a reconstructive flap or graft procedure that brings a strip of hair from another site to the eyebrow.

The patient and surgeon must agree on the procedure best suited to the needs of the patient. Eyebrow restoration procedures are usually performed in an outpatient setting. Postoperative complications are usually limited to minor pain and swelling.

Reconstruction of the Eyebrow Using Flaps or Grafts

Reconstructive surgery has been used for many years to restore missing eyebrows or to repair partially missing eyebrows. Technical considerations and the needs of the patient determine which reconstructive procedure is used:

Transplants—Either a strip of hair-bearing skin and subcutaneous tissue or individual follicular units by follicular unit extraction (FUE) are removed from a donor area on the scalp, or donor areas on the body, and grafted into the surgically-prepared eyebrow site. The transplant procedure is performed by selecting a hair-bearing area of scalp with hair that is of appropriate texture and orientation to serve as eyebrow hair. Follicular units, usually of one to two hairs, are placed into incisions to achieve the desired shape or density.

Scalp-to-eyebrow pedicle flaps— (Less commonly used) A strip of hair-bearing skin and subcutaneous tissue is raised from the temple area just in front of the ear, with its blood supply (a branch of the superficial temporal artery and vein) attached. This type of donor graft attached to a blood supply is called a pedicle flap. After the pedicle flap is raised, the recipient area (the eyebrow) is prepared to receive the flap. A subcutaneous "tunnel" is created from the base of the pedicle flap to the eyebrow recipient site; the flap is pulled through the tunnel and secured to the recipient site with stitches. The pedicle flap’s blood supply nourishes the grafted tissue until the grafted tissue develops its own blood supply from surrounding tissue. Hairs grown from grafts and pedicles may have to be "trained" with gel or wax to lay flat to the skin like eyebrow hair; grafted hair will have to be trimmed occasionally.

Transplantation to Correct Eyebrow Loss— One goal of transplantation of hair to the eyebrow is to recreate the eyebrow in a natural contour. The patient and physician must work together to outline the eyebrow area to conform to the natural symmetry of the patient’s face. Depending on the size of the area to be transplanted, more than one transplant session may be required; two or more sessions several years apart are common.

As the transplanted hairs grow in their new position they will require occasional trimming as well as "training" with gel or wax.

Eyelash Hair Restoration (Eyelash Surgery)

Thin or short eyelashes can be treated with Latisse however transplantation is the only procedure used to restore eyelash hair when it has been lost. Eyelash surgery is a very specialized procedure that is performed by just a few surgeons. As is the case for eyebrows, donor hair for transplantation must be finer rather than coarser. All grafts are single hairs meticulously placed into the lid. As few as six hairs per lid may be adequate to create a natural effect.

Itching is a common and troublesome postoperative complication. If the patient gives in to temptation and scratches, there is risk for dislodging the hair grafts and initiating infection. Eyeglasses may be worn to deter scratching. The dermatologist can prescribe medications to relieve itching.

Training of transplanted hairs into eyelash conformation is accomplished by use of lash oil and an eyelash curler.

Eye Lash Hair Transplant Surgery - History

www.drvaibhavshah.net---

 +Dr Vaibhav Shah 

+Dr Vaibhav Shah  

Eyelashes have an anatomical function of shielding the eye from injury, from dust and grit.

Eyelashes frame the eyes, and together with eyebrows, hairline, cheek bones, nose, lips and chin create the facial appearance that is unique to every individual.

A person without eyelashes has a strange appearance because they lack one of the important anatomical landmarks of facial normality.

Absence of eyelashes has a number of causes :

·         Facial injury and scarring due to automobile accidents, industrial accidents, chemical and thermal burns, eyelid tattoos, and traction alopecia associated with long-term use of false eyelashes;

·         Surgical treatment; injury or tumor that results in removal or eyelash follicles and tissue scarring;

·         Medical treatment;  radiotherapy or chemotherapy for cancer that results in hair loss;

·         Trichotillomania; compulsive hair plucking of scalp hair, eyebrows and eyelashes:

·         Congenital atrichia-congenital absence of hair on all parts of the body.

Initially used to correct loss of eyelashes, esthetic facial enhancement is a relatively recent development. Some doctors believe it should continue to be reserved only for medically necessary eyelash replacement.

Brief History of Eyelash Transplantation
90 years ago. Dr. Franz Krusius, a German physician, published his technique for reconstruction of lost eyelashes by harvesting scalp hair with a small punch and transplanting donor hair into the eyelid with a needle that he designed. In 1917, German physician Dr. P. Knapp, inserted into the eyelid border a composite free graft strip from the eyebrow. Papers published from the 1930s through the 1950s, many from Japan, continued to advance techniques of eyelash reconstruction.

In 1980, Emmanuel Marritt MD, a member of the International Society of Hair Restoration Surgery, published his technique for transplantation of single donor hairs from the scalp into the eyelid for eyelash reconstruction. In the same year of 1980, Robert Flowers MD, reported a "pluck and sew" technique of eyelash reconstruction that is in use today in revised version by physician hair restoration specialists (a revised version was described by Marcelo Gandelman MD, in the standard textbook "Hair Transplantation", Second Edition, edited by Walter Unger, MD).

Who Is a Good Candidate for Eyelash Transplantation?

1.     Reconstructive-eyelash transplantation for trauma or disease.

2.     Esthetic - eyelash transplantation to achieve an esthetic enhancement of existing eyelashes, but the hair shaft diameter and curl of the donor hair can make the outcome unattractive.

3.     Not suitable; (A congenital atrichia patient is a candidate only for eyelash prostheses that are fastened to the eyelid with adhesive.)

Physical Examination and Medical History
Every person being considered for eyelash transplantation must have a complete physical examination and laboratory tests if indicated, and must provide a detailed medical history.

Patient/Physician Consultation and Agreement
The patient and physician must agree regarding:

·         The patient's full understanding of the procedure, including possible complications and postoperative recovery;

·         The anticipated outcome (esthetic enhancement), including understanding that eyelash transplantation can achieve significant esthetic improvement but cannot achieve completely "natural" results associated with natural eyelashes (it is necessary for the patient to use an eyelash curler and to trim eyelashes for the rest of their life) ;

·         Cost; In the U.S., $5,000 to $10,000 is common.

The patient may also ask the physician for credentials demonstrating adequate training in eyelash transplantation in addition to training in hair restoration surgery. The physician should understand eyelash anatomy and esthetics, and have training and experience in methods of donor hair harvest and eyelash graft placement.

Preoperative Preparation
Every surgical procedure requires preoperative preparation.

·         anticoagulant drugs such as aspirin and warfarin (Coumadin)

·         stop vitamin E supplements

·         no alcohol

·         use an antiseptic soap for facial cleansing

·         take antibiotics if prescribed by the physician.

Techniques of Eyelash Transplantation
Donor hair transplanted to the eyelid must match the quality of eyelashes as much as possible. The transplanted hair will continue to grow in the eyelid; as it grows, the patient will have to follow a regular regimen of curling the transplants, and trimming them.

Donor areas commonly used include the nape of the neck or the area of the scalp above or behind the ears. Hairs taken from the eyebrows and legs are also used in eyelash transplantation.

Transplantation Technique

·         Eyelash transplantation is performed under local anesthesia. Mild sedation helps relaxation.

·         The surgical needle punctures the eyelid at the margin and a hair graft is placed into it.

·         Grafts are properly spaced and to prevent trichiasis . (A normal upper eyelid contains about 100 lashes, the lower eyelid about 60 lashes).

·         A session is performed in one to three hours. A desirable result may be achieved in one-three sessions. The number of sessions is dependent on patient characteristics, desired result, and the surgical technique.

Postoperative Recovery and Care

·         Pruritus (moderate to intense itching) of the eyelids frequently occurs immediately after surgery and may persist for one or more days.

·         Persistent itching beyond one day may indicate a postoperative complication that requires the physician's attention. (Itching should be differentiated from discomfort; discomfort beyond one day is normal).

·         Scratching of the eyelids will easily dislodge transplanted hairs, itching should be relieved as much as possible by ophthalmic ointments, mild analgesics such as acetaminophen (Tylenol), and ice packs.

·         Wear goggles while sleeping to prevent inadvertent eyelid scratching. Some physicians recommend keeping the eyes bandaged for the first 24 postoperative hours.

·         7 to 14 days is required for complete postoperative recovery.

·         Coat the new eyelashes with lash oil, use an eyelash curler to encourage proper curl and trim regularly.

Potential Complications

·         Eyelid infection; rapid recognition and treatment are essential to prevent spread.

·         Bruising and swelling.

·         Graft displacement caused when the patient scratches eyelids, causing failed growth.

·         Ingrown hairs.

·         Ectropion; eversion and downward pull of the lower eyelid, causing the eyelid to fall away from the eye.

·         Entropion; turning in of the upper or lower eyelid margin.

·         Poor placement or poor quality of eyelash grafts due to use of coarse hair as grafts, or placement of grafts that fails to achieve the desired esthetic result.

Medical Treatment for Eyelash Enhancement.
A class of drugs known as prostaglandins can be used as a  medical approach to eyelash enhancement. The best known is latanoprost drops, currently administered to treat glaucoma. Ophthalmologists noted that latanoprost lengthens and darkens existing eyelashes. It does not stimulate new growth.

Side effects include blurred vision, eyelid inflammation, permanently darkened eyelashes, thickening of the eyelashes, permanent darkening of the iris of the eye, and a temporary burning sensation.

The use of prostaglandin analogues for reasons other than glaucoma treatment has not been thoroughly investigated. Their use for eyelash enhancement should be approached with caution.

Eye Lash Hair Transplant Surgery - Introduction

www.drvaibhavshah.net---

+Dr Vaibhav Shah  

Eyebrow hair transplant, facial hair transplant and eyelash transplant: a guide for patients experiencing facial hair loss

                 Facial hair transplants, eyelash implants, and eyebrow restoration are becoming increasingly common options for people experiencing hair loss on their faces. There are various causes for facial hair loss, and the need for a restored beard or eyebrow hair transplant can result from physical trauma, illness, certain types of medical treatment (such as chemotherapy) or over-plucking.

                   An eyebrow hair transplant, one of the common facial hair transplants, involves transferring grafts of hair-bearing tissue from the scalp. In some cases, goal of such a surgery is to recreate the natural contour of the eyebrow, and the surgeon pays attention to maintaining the patient’s facial symmetry. Beard hair transplants use similar procedures and are becoming increasingly popular among men.

                 An eyelash transplant is a very complicated procedure and is performed by only a few surgeons. Very few eyelashes – as few as six – are needed to achieve a natural effect.

DISCUSSION ON ACNE

www.drvaibhavshah.net

Dr Vaibhav Shah

DISCUSSION ON ACNE

       Acne is a condition that is misunderstood by many patients and doctors.  First let me say that I am not a dermatologist and anyone with severe acne should see a dermatologist for their unique expertise.  Having said that, I see (as do most cosmetic facial surgeons) many patients with active acne.  In some cases patients may outgrow the acne, but a large percentage of patients may end up with permanent scarring.  This is very unfortunate, especially for young patients who don’t know better.  If any adult is reading this and they have a child with active acne, I implore them to seek treatment for their child.

Acne has little to do with what we eat and the other associated wife’s tales.

·         Myth:

Washing your face more often will help clear up acne

Reality:

Facial blemishes are not caused by dirt. Contrary to what you may have seen in commercials, pores do not get blocked from the top down due to “impurities”. Rather, the walls of a pore stick together within the skin, starting acne formation. Far from preventing acne, frequent washing may actually irritate pores and cause them to become clogged. A washcloth can add even more irritation. The best bet is to wash very gently with bare hands, and only wash twice a day.

·         Myth:

Stress causes acne

Reality:

Stress may have an effect on hormones and theoretically can promote acne. However, an effective acne treatment regimen is more powerful than a bout of stress any day. Some psychiatric medications may have acne as a side effect, but stress itself is no big deal. Your time is better spent determining the right course of acne treatment rather than feeling guilty about stress.

·         Myth:

Masturbation or sex causes acne

Reality:

This antiquated notion, originating as early as the 17th century to dissuade young people from having premarital sex, is just plain wrong. Don’t believe the hype.

·         Myth:

The sun will help get rid of acne

Reality:

The sun may work in the short-term to hasten the clearing of existing acne while reddening your skin, thus blending your skin tone with red acne marks. However, a sun burn is actually skin damage. Sun exposure causes irritation which can make acne worse. People will often notice their skin breaking out as it heals from sun damage. The sun is a short-term band-aid which will often bite back with more acne in the weeks following exposure. Having said that, I don’t want to give the impression that the sun is evil. It is not. We get our vitamin D from the sun for instance. Limiting sun exposure on acne prone areas of your body is most likely prudent, but some exposure from time to time is not only unavoidable, but is perfectly okay.

·         Myth:

Diet and acne are related

Reality:

The bottom line is we need more research. We do know that people in some indigenous societies do not experience acne whatsoever across the entire population. This is in stark contrast to the widespread presence of acne throughout all modern society. It leaves us to ponder the question of whether the indigenous people’s diet contributes to their acne-free skin. Discovering a dietary way of preventing acne may be a future reality, however, we may live so differently from our hunter/gatherer ancestors that it has become close to impossible to replicate our ancestral diet. But, let’s see if we can work together to come to some consensus from our own experiences. If you feel that you have cleared your acne using a particular diet, or if you are planning on attempting a diet of some kind, please post your method on the Nutrition & Holistic health message board.

(above taken from www.acne.org which is a very valuable resource for patients)

 Acne is a condition that is a result of a bacterial skin infection.  The bacterium P. acnes lives in the pores and with an increase in sebum (oil gland) production it causes the pustules and sometimes cysts that we call zits.  Some acne is associated with comedones (blackheads) while cystic acne is more of an inflammatory process.  Severe acne requires treatment with such medications as Accutane and is essential to have a qualified dermatologist when using this type of drug.

For the more garden variety acne cases that I see in cosmetic patients or their children, the treatment includes numerous factors.  Skin care is one of the most important.  Very few patients take a serious approach to medically based skin care.  Simple skin care with cleansers, toners, a retinoid (such as Retin-A) can assist acne prevention and treatment.  Oral antibiotics such as Minocycline are frequently used once a day and topical antibacterial wipes (1% cleocin) used twice a day have worked well in my practice.

Ancillary treatments such as microdermabrasion can assist exfoliation.  A recently approved LED single wavelength light treatment has also been useful with a nonsurgical, nonprescription treatment regimen.  I have one of the few LED devices in the area.  This FDA approved acne treatment involves the patient sitting in front of an LED device for 20 minutes, twice a week for about a month.  This simple treatment has benefited many patients in my practice.  This treatment is more beneficial for inflammatory acne than “blackhead” type of acne.  Although some patients do not respond to the Omnilux, most do and it is an affordable option to more aggressive treatments.

Finally, for patients that have acne scarring, multiple options exist to improve the scars.  The CO2 laser is the gold standard for acne scarring and can produce dramatic improvement.  Other treatments for acne scars include injecting fillers under the scar, subcision (undermining the scar with a special needle) and surgically removing the scar.  I perform all of these treatments for acne scarring and frequently combine these treatments, depending upon the severity of the acne scars.  Acne patients need to be careful not to be taken advantage of.  There are many devices, new lasers and practitioners that promote or promise miracle cures.  If a miracle cure existed for acne, no one would have it.  Although the newer lasers such as the fractional lasers may show promise, the results have been disappointing in my experience.  I have yet to see any treatment that can compete with the CO2 laser.  Although the recovery a hassle, the results are predictable and reliable.

If you have a loved one, friend, or coworker with acne, encourage them to seek treatment before they develop scars.  For those patients that already have acne scars, an experienced cosmetic facial surgeon can improve their appearance and self confidence.

Acne & Isotretinion

www.drvaibhavshah.net

 +Dr Vaibhav Shah 

         ACNE

      Sounds like a headline from the National Enquirer!  After decades of safety of use in millions of patients (including this author!), a recent report has raised some eyebrow when a recent study made some alarming claims.  Relax, you are not going to die, but read on to learn some interesting facts that could affect your health.

           Retin A (generically known as tretinoin), a Vitamin A analogue that is a popular acne medication and has been used by physicians to prevent skin cancers, treat wrinkles, and prevent skin aging, has been criticized in a recent study for increasing the risk of death in some patients. Even though these products have been used safely and effectively for many years, a recent study by Weinstock MA et al, published in the Archives of Dermatology, showed that patients treated in a VA hospital with 0.1% tretinoin topically to prevent skin cancer had a higher risk of death than those not using tretinoin. The veterans in this study were predominately elderly men.

          The researchers looked at various factors in the study to try to determine the explanation for the increased number of deaths among tretinoin users. It is difficult to know for sure because the study was not designed to look for risk of death, but it seems that it is smokers who are at greater risk. This finding goes along with a study looking at an oral form of Vitamin A called isotretinoin that showed that isotretinoin may be harmful to current smokers. It is important to realize that this is the first sign of a risk of harm from using tretinoin after decades on the market, so this study’s results may not hold up when more testing is done. However, it is prudent to take this advice: If you use tretinoin (retinol, adapalene, tazarotene) or take Vitamin A or beta carotene supplements, please do not smoke. Smoking is known to age your skin prematurely and to cause lung disease and heart disease. It now looks as if using popular anti-aging products in addition to smoking may increase your risk of death.

---

History of the Orthognathic Surgery

www.drvaibhavshah.net

  +Vaibhav Shah

History of the Orthognathic Surgery.

While an exhaustive history is not possible, a brief chronologic history of orthognathic procedures follows.

Mandibular osteotomies

1846 - Hullihan - Anterior mandibular subapical osteotomy and setback

1906 - Blair - Mandibular body osteotomy

1907 - Blair - Horizontal osteotomy of the ramus, external approach

1925 - Limberg - Posterior oblique vertical ramal osteotomy, external approach

1927 - Wassmund - Inverted "L" ramal osteotomy, external approach

1939 - Kazanjian - Beveled horizontal osteotomy of the ramus, extraoral approach

1942 - Schuchardt - Step horizontal osteotomy of the ramus, intraoral approach

1954 - Caldwell and Letterman - Vertical ramal osteotomy, external approach

1955 - Obwegeser - Sagittal split ramal osteotomy

1968 - Caldwell et al - "C" ramal osteotomy

1970 - Hebert, Kent, and Hinds - Intraoral vertical ramal osteotomy

Maxillary osteotomies

1927 - Wassmund - Le Fort I osteotomy with the pterygomaxillary junction left intact; elastic forces used to bring the maxilla forward

1928 - Axhuasen - Segmental osteotomy through the mid palate

1942 - Schuchard - Staged Le Fort I osteotomy, followed by pterygomaxillary separation; external traction used to bring the maxilla forward

1949 - Moore and Ward - Horizontal transection of the pterygoid plate

1965 - Obwegeser - Fully mobilized the maxilla; in a single step brought it into the predicted position

Osseous genioplasty procedures

1942 - Hofer - Horizontal sliding osteotomy of a receding chin (extraoral)

1957 - Trauner and Obwegeser - Intraoral approach to osseous genioplasty[1]

Historically, the ability to reposition the mandible in a stable manner long preceded the ability to reposition the maxilla. As a consequence, many patients underwent only mandibular surgery to correct a primary maxillary deformity. The specialty of orthognathic surgery did not fully develop until Obwegeser demonstrated the possibility of repositioning the maxilla in a stable consistent manner in 1965 and reported simultaneous repositioning of the maxilla and mandible in 1970.

Medical Tourism

www.drvaibhavshah.net

  +Vaibhav Shah 

                                     Medical Tourism

With the extreme interest in cosmetic surgery many new avenues have appeared to mix surgery and recovery and medical tourism is one of them.  Medical tourism is the idea of having cosmetic surgery and recovering at a remote destination, usually a luxurious one.  On the surface, this may sound cool, but in reality, who really wants to spend their vacation with swelling, bruising, stitches and bandages.  I guess one could make an argument that the patient could go to the vacation spot a week early and enjoy the vacation, then have surgery and recover the second week.  This way, one can combine vacation and recovery…………….but why?  Personally, I can’t fathom combining the two.  I work hard and when I go on vacation, I want to enjoy it.  I don’t want to spend it in bed, especially in a recovery bed.  Another thing to consider is what type of medical facilities are available at the luxury destination.  I have been to some really beautiful places in my life, mountains, islands, wonders of the world, etc.  Few of any of these localities are known for their medical facilities any more than Cleveland Clinic is known for a vacation Mecca.  The news is replete with horror stories of patients that went to Mexico or South America for a “bargain” surgery and vacation and lived to regret it.  When I go on holiday, I want the best chefs, bartenders, and tour guides, when I have surgery I want the best facilities, medical staff and emergency equipment.  I think it is rare to find the combination of all of the above.  Not impossible, but uncommon.  Sunscreen or penicillin? Pina colada or pain pill?  Not the choice for me.

Non-Surgical Rhinoplasty

www.drvaibhavshah.net

  +Vaibhav Shah 

Non-Surgical Rhinoplasty

       The importance of a well-balanced nose cannot be overemphasized. As one of the most prominent features of the face, the nose is essential for facial harmony and, for many people, a positive self-image. For men and women frustrated by the appearance of their nose, dramatic improvement can often be accomplished with nose surgery (rhinoplasty); however, Mumbai facial plastic surgeon Dr.Vaibhav Shah has discovered that dermal fillers can achieve attractive results for certain patients.

Indications-

Building the bridge (augmenting the dorsum).

Refining the results of nose surgery (filling in small defects).

Correcting asymmetry and concavities.

Tip enhancement (adding dimension or improving the shape of a flat tip).

Smoothing or straightening the nasal hump.

Benefits of Nose Dermal Fillers

There are several benefits to nose dermal fillers.

Fillers are temporary. This means that, should a patient be dissatisfied with the improvement, the results will fade and a new approach can be attempted.

The changes that can be accomplished are natural-looking.

Dermal fillers are versatile, so Dr. Shah is able to achieve delicate, very specific improvements. This type of precision may not be possible with nose surgery.

Results are visible very soon after the procedure (if not immediately), whereas results from nose surgery can take up to a year to refine.

The patient is conscious during the procedure, so they can provide real-time guidance to ensure the results meet their expectations and goals.

No downtime is required after the procedure. There may be some minor bruising or redness, but makeup can be applied immediately to minimize these effects. Patients can return to work or their usual routine right away.

Non-Surgical Revision Rhinoplasty

Facial fillers are a good alternative for patients seeking revision rhinoplasty. Surgical rhinoplasty may result in a weakened nasal structure making the nose more susceptible to injury when subjected to additional surgeries. Small deformities or irregularities on an otherwise ideal rhinoplasty outcome may be challenging to correct with surgery. Fillers are better at contouring than surgery, as they provide the ability to treat deformities without disrupting adjacent areas.

Limitations, Risks, and Reversibility

Non-surgical rhinoplasty has many advantages, but there are also some associated risks and drawbacks. It is important that you fully understand both the advantages and disadvantages of this procedure before undergoing treatment.

Risks & Limitations

Because dermal fillers are not permanent, patients will need to return approximately every 6 months for touch-up treatments. Additionally, non-surgical rhinoplasty cannot narrow cartilage or reduce the size of the nose. Unwanted side effects such as bruising, swelling, or redness may also occur. You can learn more about the risks associated with non-surgical rhinoplasty by visiting our Rhinoplasty Risks page.

Reversibility

One of the greatest benefits of non-surgical rhinoplasty is that the procedure is reversible in most cases. If a patient is unsatisfied for any reason, a special enzyme known as "Hyaluronidase" can be injected into the treatment area within the first 24 hours. This enzyme immediately dissolves hyaluronic acid fillers such as Restylane®, JUVÉDERM®, and Perlane®. RADIESSE® is typically more difficult to dissolve, but can be reduced by about 30%. Ultimately, the effects of dermal fillers are temporary as they are naturally reabsorbed by the body over the course of a few months.