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Alexander Rivkin, MD
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Alexander Rivkin, MD
Plastic surgeon | Views: 244030


Friendname: AlexanderRivkinM.D.
Business Name: Westside Aesthetics
Website: www.westsideaesthetics.com
 
Location: 1033 Gayley Ave #104
los angeles, CA 90024
United States
Telephone: 310 443 5273
Languages Spoken: English




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Ask An Expert > Alexander Rivkin Message Board > How is the injection of fillers into nose executed in a non-surgical nosejob?
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maria17
lhr, Pakistan
How is the injection of fillers into nose executed in a non-surgical nosejob?
In a non-surgical nosejob i got recently, the filler was injected from inside of nose.i had a prior notion of injectible being injected from outside into skin.Wonder why it had to be done this way in my case? is there anything unusual about it?


 



drgrossman
Plastic surgeon
New York, NY
United States
View My Professional Profile
  March 14, 2012 6:17 PM

This wonderful procedure can be done in as many ways as people cook. As long as you like the results, why should it matter.
Good luck from NYC.
For more info visit www.drgrossman.com


arnioldkleinmd
Dermatologist
beverly Hills, CA
United States
View My Professional Profile
always inject from outside in!  March 15, 2012 10:56 PM


For decades, patients have searched for ways to maintain a youthful appearance through cosmetic intervention. In recent years, the trend has been toward nonsurgical procedures (82% of the nearly 12 million cosmetic procedures in the US in 2007). Over the last decade, nonsurgical procedures increased by 754%. Those procedures involving hyaluronic acid (about 1.5 million) are second only to botulinum toxin (Botox® Cosmetic) injections (about 2.8 million).3

Thirty years ago the procedure involved bovine collagens, which first provided for safe, stable, and natural-looking lip enhancement. However, the improvement collagen provides is temporary and has been associated with hypersensitivity, leading to a search for other options.4 Non-animal, stabilized hyaluronic acid (NASHA?,Juvederm® Restylane® was developed as an alternative; hyaluronic acid is a polysaccharide occurring naturally in the dermis and offering a lower potential for immunogenicity and hypersensitivity and a more lasting outcome.5 NASHA is composed of small particles of hyaluronic acid molecules stabilized by cross-linking. This stabilized gel exhibits improved resistance to enzymatic degradation and can bind significant amounts of water. These properties contribute to its longevity in cosmetic procedures. Proper injection technique is essential in achieving accurate correction and an aesthetically pleasing result. The author has developed the anterior or serial puncture technique which allows the gentle forward flow of the material for the slow injection of a small amount of product, thereby decreasing lumps or bruises. To control proper placement of a filler and to avoid infection I would never inject inside the nose or the oral cavity,

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always inject from outside in!



maria17
  March 17, 2012 4:26 AM

Appreciate the detail, Dr.Klein! Dr.Grossman, am concerned in this regard because the deficiency in contour,the fillers were meant to fill in, now appear more prominent and deepened as the result has faded away.Does scarring has anything to do with it?


maria17
  March 17, 2012 6:58 AM

*i suspect the asymmetries appear worse in certain ways.is it the injection techique or is it going- back- to- pre procedure nose thing,after temporarily being accoustomed to the fillers' benifits?? Illusion?? utterly confused!


drgrossman
Plastic surgeon
New York, NY
United States
View My Professional Profile
  March 17, 2012 11:17 AM

If there was scaring present prior to the fillers, then yes, scar tissue can cause displacement of the filler where it is not wanted.
Good luck from NYC.
For more info visit www.drgrossman.com


AlexanderRivkinM.D.
Plastic surgeon
los angeles, CA
United States
View My Professional Profile
My preference is to inject from the outside in.  March 19, 2012 11:07 AM

I always inject from the outside in. My reasoning is that the changes we are trying to effect in the nose are very precise and small. therefore, the injections should be exactly in the places that you want these changes to occur. Injecting from the inside seems to me to be an unnecessarily indirect method, since injection through the skin has been shown over the years to be a very safe and effective technique. If anything, the procedure should stimulate collagen growth in the areas injected and the appearance, once the filler dissolves should be better, not worse than when you started. I think this is an illusion - you may have become used to the post injection appearance. Hope that helps


maria17
  March 22, 2012 1:54 AM

Thank you so very much for addressing my concern, Dr.alexander. just one more thing though, what bad affects could occur if the filler is placed from the inside,any affect to the nasal framework or shape??


AlexanderRivkinM.D.
Plastic surgeon
los angeles, CA
United States
View My Professional Profile
  March 22, 2012 12:26 PM

no, i don't think it is harmful to inject from the inside


maria17
  March 26, 2012 10:12 AM

Thank you again, Dr.Alexander! A bit relieved to know that the procedure,as such doesn't entail much harm.Want to share a brief description of what was done in the procedure. A curve along the right sidewall was filled out( middle part of the nose), and a depression on the left side of tip was filled, to make nose look straighter on the front. At this stage, as the filler has dissolved, the nasal outline in the treated areas appear a bit more caved in, hollow and shadowy than before.Also it's the only cosmetic treatment I'd ever had to my nose, but have endured a few traumas.
Will attach pics in a few days.Would be truly obliged to hear your thoughts on the issue! Respect and regards.


arnioldkleinmd
filler used and how many injection sessions  March 27, 2012 1:49 AM

Can you please tell me the injectable used and the number of sessions.


maria17
  March 28, 2012 4:06 AM

It was hyaluronic acid filler, and was done in a single session. Other than that, i do have an anatomy that is delicate and a bit twisted in the lower half. If that could be a determining factor, i wonder??


docblinski
Plastic surgeon
Miami, FL
United States
View My Professional Profile
  March 28, 2012 5:34 AM

I do not feel either way to inject is the issue. The issue is the result obtained.


arnioldkleinmd
probem with the injection  March 29, 2012 2:45 AM

I think the best way to correct a superficial defect is by injecting from the outside of the nose which is the issue here.


maria17
  March 31, 2012 9:02 AM

@ docbilski, the result ,could which be the aftereffect of a faulty technique? Regard


docblinski
Plastic surgeon
Miami, FL
United States
View My Professional Profile
  April 2, 2012 6:09 AM

Yes, faulty injection techniques are the most likely issue here.


maria17
  April 3, 2012 9:12 AM

@docblinski, in utter regret, i wanted to ask, are such undesireable results permanent? is there any going back?


arnioldkleinmd
Dermatologist
beverly Hills, CA
United States
View My Professional Profile
to correct the defect.  April 3, 2012 10:02 AM

To best correct any given defect often takes the injector and a nurse to see how the correction fills as it is performed.This is how I get the results I do!


arnioldkleinmd
Dermatologist
beverly Hills, CA
United States
View My Professional Profile
to correct the defect.  April 3, 2012 10:02 AM

To best correct any given defect often takes the injector and a nurse to see how the correction fills as it is performed.This is how I get the results I do!


docblinski
Plastic surgeon
Miami, FL
United States
View My Professional Profile
  April 4, 2012 8:21 AM

Results depend upon the type of filler use as to the longevity of it. Regards




 



 

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