Dr. Sam Lam Plastic Surgery Forum

can non-surgical injections create a nice tip if injected over a bulbous tip? what are risks associated with this procedure, and how much does it cost?

two things: no and no. let me explain.
1. injectable rhinoplasties fail in the nasal tip because the skin will not stretch there. it will only truly work well in the bridge, where the nose is less mobile BUT the skin is mobile and not adherent to the bone like it is in the tip where the skin is adherent to the cartilage.
2. a bulbous tip will look more bulbous with a filler. in a caucasian nose, it should be surgically reduced and refined in most cases. in an ethnic nose with thick skin, a cartilage graft should be used to stretch the skin like a tent after the skin has been separated from the underlying cartilage surgically. o/w as mentioned it won't work.
hope that is clear.
best,
sml

have you ever used this procedure to slenderize a flat nose bridge (by adding height)? if so, how are the results? if the skin on the bridge is thin, would you be able to see the filler? i have seen such results on people with bad nose jobs where the new bridge is visible under the skin and takes on a whiter color than the rest of the nose: it's very obvious that something foreign was there. I can't find any good pictures of the non surgical nose job for purposes other than straightening out bumps.

yes, all the time. however, as i have said, it is intended for subtle augmentation o/w you flatten the tip out, i.e., the bridge swallows the tip. nevertheless, it is very effective minus the limitations enumerated. as far as seeing the implant, that is something typically from solid silicone not really so much from injectable rhinoplasty if done right.
best,
sml

is it possible to do the non-permanent filler first to see the results and then do a permanent silicone filler later, or does the residue from restylane affect the permanent results?

Also, does the silicone have the same time flexibility to allow you to mold the material to the desired look in the first 30 minutes like restylane does?

1. as i believe i may have mentioned, it is not ideal to do a temporary filler or any kind of filler if i am contemplating a real rhinoplasty. however, if i think a little product is all you need, then i will help guide you when i see you during the consultation.
2. the non-permanent filler can be done to show you how the bridge would look. again, if you need tip work, you need a rhinoplasty and you should go that route.
3. if you do restylane, i would probably dissolve it out, wait a couple of weeks before contemplating silicone.
4. silicone is something that you do not mold or shape. you put little droplets in there and place it exactly where you want it because by doing so it won't move or shift. usually silicone requires a couple to 3 rounds to get the desired result spread a month apart.
best,
sml