Hyaluronic acid injections for the nose

Hyaluronic acid injections are widely performed because they are easy to receive with little downtime.

I'm afraid of surgery, so please make my nose taller with hyaluronic acid."
I'd like to give the tip of my nose a twang with hyaluronic acid."

We also receive inquiries about this.

How does hyaluronic acid injections in the nose really work?"

I have been asked to explain my thoughts on this issue.

First, let me conclude.

Injection into the dorsum of the nose (nasal stripe) is possible.
Injection into the tip or bridge of the nose should be considered with caution.

will be.

The reasons for this are explained below.

My thoughts and explanations

The question of whether it is effective

First try pressing your own nose from top to bottom with your fingers.
The upper 1/3 can touch the nasal bone with a click.

If you slide your finger from there toward the tip of the nose, you will find a foundation that is not as deep as the nasal bones but does not sink easily when pushed. This is the nasal septum cartilage and lateral nasal cartilage.

When you get to the tip of the nose, the ticking tissue is gone and you can touch the cartilage that moves freely. This cartilage is the nasal wing cartilage.

Next, use your thumb and forefinger to pick up the skin of your nose from the top.

The most concave area between the eyes can be picked out. This is the area of the nose where the skin is thickest.

Let's go down a little and pick up the skin around the border of the nasal bone and cartilage that we touched on earlier. You can also pick up here. This is the thinnest part of the nose.

Lastly, the skin on the tip of the nose. It may be difficult to pick it up as you have done in the previous areas. You can see that the skin is thicker and harder.

It is not limited to hyaluronic acid, but when something is transplanted to change its shape, it is advantageous if the foundation is firm and the skin is easily stretched.

In other words, the dorsum of the nose is easy to change with hyaluronic acid injections, while the tip of the nose is difficult to change.

If auricular cartilage grafting works so well, wouldn't injecting hard hyaluronic acid be able to change the tip of the nose as well?

Some may ask the question, "What is the best way to get the best results?

However, there is a critical difference between surgical cartilage transplantation and hyaluronic acid injection.

The skin of the nasal tip (or more precisely, the subcutaneous tissue group) is firmly attached to the cartilage of the nasal tip.

Surgery removes skin and cartilage to create room for growth that is transformed into skin.

However, that manipulation is not possible with hyaluronic acid injections, so injecting hard hyaluronic acid does not produce the same results as surgery.

Safety Issues

The skin of the nose has a five-layer structure, from top to bottom: skin, superficial fat layer, fibromuscular layer, deep fat layer, and cartilage membrane. In the case of surgery, which layer is to be peeled off is determined according to the purpose.

If hyaluronic acid is to be injected into thick tissue such as the tip of the nose, it is tempting to inject into the shallow to middle layers. However, blood vessels that nourish the skin of the nose run in the shallow to middle layers, increasing the risk of hyaluronic acid being injected accidentally into the blood vessels. The risk is low for injections near the suprachondral area, but the effect will be less effective in creating a taut appearance.

The skin of the nasal bridge is soft and can be changed with hyaluronic acid injections, but the nasal bridge has a nasal artery running through it. The nasal arteries are always encountered during open surgery, but there are variations in the way the arteries run, so it is difficult to tell from the surface of the skin where the arteries are safe.

The tip of the nose and the bridge of the nose are always at risk of serious complications such as skin necrosis caused by hyaluronic acid-induced blood circulation problems. Injection of hyaluronic acid into the tip of the nose is associated with high risk and low benefit.

In the dorsum of the nose, the risk of injecting into the blood vessels can be largely avoided if the injection does not deviate from the midline.

For the above reasons,

Injection into the dorsum of the nose (nasal stripe) is possible.
Injection into the tip or bridge of the nose should be considered with caution.

We think that this is a good idea.

summary

If hyaluronic acid is to be injected into the nose, it is safer to ask a doctor who routinely performs nasal surgery and can visualize the layered structure of the nose from the feel of the needle tip.

Early detection and treatment of hyaluronic acid-induced hematochezia of the skin is important. Early detection requires experience and the ability to observe and not overlook the slightest change in skin tone. Although hyaluronic acid injections are a simple and easy procedure, it is important to consult a doctor whom you can trust.

Assistant Director Daiki Kuroda

#Dr. K's In-Depth Commentary Series