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    Refining the nose with a needle


    Nasal Injection Tips

    The most important thing the provider must do during a nonsurgical rhinoplasty is inject into the right plane, according to Dr. Kontis.

    “We need to be in the plane just above the periosteum or perichondrium. If you’re more superficial to that, you risk vessel embolism or occlusion, which can cause tissue necrosis and even blindness,” she says.

    Only small amounts of filler are needed for nonsurgical rhinoplasty.

    “You would never use a whole syringe of product in the nose. You use little, tiny amounts. I put a little in and massage it into place; inject a little more and massage it; and just go very slowly until I get the result I want,” she says.

    Also, be careful because you’re filling into a soft-tissue envelope.

    “You don’t want to inject so much product that you increase the pressure on the skin which could also decrease the blood supply and result in tissue necrosis,” Dr. Kontis says.

    Dr. Kontis says she uses only a topical anesthetic because patients tolerate the procedure very well. And after the nonsurgical rhinoplasty, patients note instantaneous results and can return to their normal routines.

    Dr. Kontis also uses fillers to nonsurgically address nasal valve breathing problems.

    “If you think about fillers being like a cartilage graft, you can pretty much do with fillers what you do with cartilage. So, when people breathe in and one nostril collapses because it doesn’t have enough support, you can use filler as a structural graft to support the ala,” she says.

    Her filler choices when addressing nasal valve problems are the same: Restylane and Radiesse.

    “The internal valve is inside the nose where the septum up high meets the sidewall of the nose. It makes a narrow V-shape. Surgically, we perform nasal valve surgery, where we put in grafts called spreader grafts. Filler is supportive enough to act like a spreader graft. It can be injected into the lateral aspect of the internal valve to stent it open, so it doesn’t collapse when the patient breathes in,” Dr. Kontis says.

    Disclosure: Dr. Kontis is an injector trainer for Galderma and Allergan.

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...


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