"Cut or Inject"—The Way of Thinking About Improving a "Low Nose" Revealed by Research Data
Do you know the treatment that many patients showed high satisfaction with?
- The pros and limits of hyaluronic acid and surgery
- The deformity risk that can occur with implants and the research data
- Why autologous cartilage is said to be a long-term improvement method
- Points for identifying the treatment that suits you
"Easy injection, or surgery that can be expected to have a semi-permanent effect"—the method for treating a low nose is something to agonize over. Based on evidence, let's find the option that suits you together.
Why Do People Worry About a "Low Nose" in the First Place? Knowing the Ideal Balance
The concern of a low nose is not merely insufficient height; it is often influenced by the overall facial balance. In cosmetic-medicine research, the ideal beauty of the nose is said to be determined by the "proportions of the face."
For example, there is data showing that the ideal is for the width of the nostrils (alar width) to equal the distance between the eyes (intercanthal distance). The lowness of the nose is determined not only by the height of the bridge (dorsum) but also greatly by the height and orientation of the nasal tip.
A state where the bridge is low and flat is called a "saddle nose," and it becomes a cause of the whole face losing dimensionality. Just blindly raising it without understanding this anatomical structure may produce an unnatural result.
In fact, more than how many millimeters to raise it, achieving harmony of the whole face is the key to creating a beautiful nose. So, what specific improvement methods are there?
Can "Hyaluronic Acid for Now" Really Fix the Concern of a Low Nose?
When you hold the concern of a low nose, the improvement method that first comes to mind may be filler (injectable) treatment such as hyaluronic acid.
hyaluronic acid injectionSatisfaction with treatment is high; for example, a review by Signorini et al. (2016) reported that patient satisfaction with filler treatment including rhinoplasty reaches 80–95%—first let's look at this research data.
Filler treatment has the major advantages of little downtime and immediacy. By injecting at the appropriate depth—above the periosteum (just above the bone)—height can be produced while preventing unnatural swelling.
However, filler augmentation has the unavoidable wall of "duration." It differs by product type, injection site, and individual variation, but the rough benchmark is generally from a few months, and at most about 18 months (Signorini et al., 2016). In other words, to maintain a high nose, you need to repeat regular injections.
The Risk Lurking Behind the Convenience? Why "Injection Only" Hits a Limit
Filler treatment is easy and high in satisfaction, but it's not all-powerful. Behind the convenience, there are also medical risks and limits.
Risks accompanying injection treatment include, besides swelling and redness, the formation of lumps, or migration in which the injectable flows to the surroundings.
Furthermore, as a serious risk,vascular embolism (the injectable clogging a vessel)can be cited. Important vessels run around the nose, and if they get clogged here, there is the danger of causing tissue necrosis and the like.
Also, because it is a soft jelly-like substance, there are limits to producing fine changes in form such as making the nasal tip sharp, slim, and high.
The Advantages and Long-Term Risks of Implant Augmentation Rhinoplasty
As a method of raising the nose with surgery, there isaugmentation rhinoplastyusing a silicone implant. It is a very popular improvement method especially among Asians.
Do you think "once an implant is in, I'm safe for life"? In fact, the real change may begin from there.
Silicone is an artificial material, so in the body it may cause aforeign-body reaction (the body's response trying to eliminate the foreign object).
Due to this reaction, a capsule forms around the implant, and its contraction may cause the phenomenon of "capsular contracture."
In a study by Hong et al. (2024), it was reported that when contracture becomes severe, the nasal skin and mucosa are pulled, possibly causingthe "short-nose deformity (pig nose)" in which the nose becomes short and turns up.
You need to understand that surgery using a foreign material always carries such risks. So, how can you produce height while suppressing the risk more?
Raise the Nose With Autologous Cartilage! The Long-Term Improvement Method Research Supports
Implant augmentation rhinoplasty is one effective method for raising the bridge, but long-term risks must also be considered.
If you seek long-term safety and a natural result, surgery usingautologous cartilage (cartilage harvested from your own body)is recommended. Rib cartilage (the cartilage of the ribs) in particular can be harvested in sufficient quantity and has strong support, so it is regarded as a material suited to reconstructing the foundation of the nose.
The advantage of autologous cartilage is that, because it is one's own tissue, the risk of a foreign-body reaction is said to be low.
"But won't the cartilage be absorbed and decrease?" you may worry. Indeed, grafted cartilage is sometimes absorbed over time due to individual variation.
However, it is said that with appropriate design at the time of surgery, long-term maintenance of the ideal height is possible.
Rib cartilage also has the risk of warping, but it is said that using the technique of symmetrically shaving the central part of the cartilage can minimize this risk.
Which Is Best After All? A Thorough Comparison of Hyaluronic Acid vs. Implant vs. Autologous Cartilage
"So which is best after all?" Let's compare the three methods explained so far.
- Injection treatment such as hyaluronic acid: suited to those who don't want a scalpel and want to first try a little change. However, the duration is a few months to about 18 months, requiring regular maintenance.
- Silicone implant: suited to those who want a firmly straight bridge. However, the deformity risk from a foreign-body reaction or capsular contracture must be considered.
- Autologous cartilage grafting: an option suited to those who want a long-term change safely with their own tissue. Rib cartilage and the like can produce sufficient height. However, it has the drawback that a scar also forms at the site where cartilage is harvested, such as the chest or ear.
Each method has its pros and cons, and the optimal option differs by the current state of the nose and how much change you desire.
Aiming to Resolve the Concern of a Low Nose. The Conditions for a Clinic Choice You'll Be Satisfied With
To resolve the complex of a low nose, choosing a physician who explains not only the advantages but also the accurate risks based on medical evidence is very important.
"Whether the surgery succeeds" depends on accurate pre-op diagnosis and on the patient and physician sharing the goal setting. Choosing a clinic that can offer proposals based on medical evidence raises the chance of making a choice you'll be satisfied with.
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Summary of This Article
- Injection treatment is easy and high in satisfaction, but on the flip side the effect disappears in a few months to about 1.5 years
- Implants, due to a foreign-body reaction, carry the risk of "contracture" in which the nose becomes short and deformed
- Autologous cartilage, being one's own tissue, is said to carry a low risk of foreign-body reaction, but the slight absorption risk and the scar at the harvest site must be considered
- The effective improvement method differs by the desired change and the tolerable risk
If anything concerns you, please feel free to consult us first. Zetith Beauty Clinic offers consultations based on medical evidence.
References
- Rohrich R, Savetsky I, Suszynski T, et al. Systematic Surgical Approach to Alar Base Surgery in Rhinoplasty. Plastic & Reconstructive Surgery. 2020 (DOI)
- Hong D, Oh J, Wang J, et al. A Grading System-Guided Approach to the Severely Contracted Nose. Aesthetic Plastic Surgery. 2024 (DOI)
- Lee Y, Choi Y, Bae C, et al. Crushed Septal Cartilage-Covered Diced Cartilage Glue (CCDG) Graft: A Hybrid Technique of Crushed Septal Cartilage. Aesthetic Plastic Surgery. 2022 (DOI)
- Buhsem O, Kirazoglu A. Agarose Gel: An Overview of the Dermal Filler and a Clinical Experience With 700 Patients. Aesthetic Surgery Journal Open Forum. 2023 (DOI)
- Daniel R, Kosins A. Current Trends in Preservation Rhinoplasty. Aesthetic Surgery Journal Open Forum. 2020 (DOI)
- Yaremchuk M, Kachare S. Invited Discussion on: Paranasal Augmentation Using Diced Costal Cartilage for Midface Concavity—A Retrospective Study of 68 Patients. Aesthetic Plastic Surgery. 2022 (DOI)
- Frederick J, Kim J, Yoo D. Asian Male Blepharoplasty and Rhinoplasty. Facial Plastic Surgery Clinics of North America. 2024 (DOI)
- Gibson T, Davis W. The distortion of autogenous cartilage grafts: Its cause and prevention. British Journal of Plastic Surgery. 1957 (DOI)
About the Author
Hiromitsu Nakamura M.D.
Zetith Beauty Clinic Ginza, Osaka, Fukuoka
Has a track record of research presentations at domestic and international conferences, and is also involved in technical guidance and education across Zetith Beauty Clinic. Specializing in precise rhinoplasty based on anatomical evidence, he pursues natural results tailored to each person's bone structure and tissue.