Dr. Sam Lam Plastic Surgery Forum

Hi Dr. Lam,
I really want to augment my nose bridge but at the moment I'm thinking of first having a dermal filler-Restylane to get a feel of the outcome, would it be safe to then get the asian rhinoplasty after the Restylane has gone?
Plus I want a tip plasty, aside from making it a bit sharper can you lower my tip a little too? Also would you be able to fix my very slight asymmetric nostrils and make them even?
Thank you!

1. yes, you can get restylane first but in general not a good idea for two reasons. it does create a little bit of scar tissue in there that i don't like. also, it stays like 1 to 3 years so you never know when it is gone. you can dissolve it but then that causes more trauma to the area. going to someone that does a conservative but beautiful procedure (not too high) is the key. also, fillers in a nose do not accurately give you an impression per se of an implant because sometimes the increase in size of the bridge can make the tip look shorter due to a relative size imbalance. again, doing this with someone with a good eye not to create that problem is important so you do not get a misinterpretation of the result. in general, a little restylane done one time would probably be ok.
2. yes, in many cases you can derotate or bring a nose tip down but i would have to see you to make that determination. fixing asymmetric nostrils is virtually impossible. you can never get it just right and it is not worth trying. that would be a big mistake.

Is it not even possible to insert some kind of very small implant or inject a little filler to fix asymmetric nostrils? From the frontal view one of my alar-sidewalls needs to be a tiny bit longer downwards in order to match my other one.
Thank you for your time!

if one is slightly retracted upwards then yes a little filler can bring it down. probably will not be exactly the same as the other side but it can be improved. i use both temporary (restylane) and permanent (silicone and artefill) products to do the job.
best,
sml

Dr. Lam,
I have a question similar to the posted one, but it is vice versa. My main issue is that I feel that my nose is bulbous, the tip is wide and round and my nostrils are quite puffy looking as well.

I was wondering if I could have surgery without having an implant put in. I would like my nostrils to be reduced, as well as my tip to have a more refined appearance. Is it possible to just have my nostrils and some of my tip reduced (basically just removal of tissue)?

I would be happy with getting just that done. I'm entirely too uncomfortable with the idea of an implant getting infected or shifting or looking too artificial. So my proposal is this: surgery for reduction and a filler such as juvederm to build up my bridge and tip. I like that juvederm is temporary and fixable. Please let me know if this is possible and if it would be a good idea.

Thank you so much for your time and consideration, I look forward to hearing your professional opinion.

yes, that is possible. i would have to see whether you are a good candidate for the tip too. as far as the bridge, you can also go with permanent injectables if the temporary version looks good to you. examples would be silicone injections or artefill.
best,
sml