Liquid rhinoplasty

What it can achieve

Carefully placed filler can smooth the appearance of a dorsal hump by filling above and below it, provide a small amount of tip lift and projection, improve apparent straightness in mild deviation, and refine the transition from nose to forehead.

It is a good option for someone with a specific, modest contour concern who does not want surgery.

What it cannot achieve

It adds volume. It cannot reduce the size of a nose, narrow a wide tip or wide nostrils, correct significant deviation, or improve breathing. If your concern is that your nose is too large, filler is the wrong treatment and will make it slightly larger. Anyone who tells you otherwise is selling rather than assessing.

It is also temporary, lasting months rather than years, and requires repeat treatment.

The risk that deserves particular emphasis

The nose has a relatively poor blood supply from vessels that are variable in position, and it is the site most associated with serious vascular complications from filler. Occlusion here can cause skin necrosis of the nose and, because of connections to the ophthalmic circulation, carries a small risk of visual loss including permanent blindness.

These events are rare, but they are documented and they are catastrophic. This treatment should be performed only by someone with detailed knowledge of nasal vascular anatomy, using cautious technique, aspirating and injecting slowly, who recognises the early signs of occlusion and has hyaluronidase immediately available with a clear protocol.

Previous surgical rhinoplasty distorts the anatomy and increases the risk further. That history changes the assessment significantly.

Consent

Given the risk profile, you will be given the full picture and time to consider it. If you are not comfortable with the risks, declining is an entirely reasonable decision and it will not be argued with.

Risks and limitations

No treatment is without risk, and you are entitled to the full picture before you decide rather than a summary afterwards. These are discussed with you individually at consultation, in the context of your own history.

• Vascular occlusion causing skin necrosis of the nose
• Visual loss, including permanent blindness — rare but reported
• Bruising, swelling and tenderness
• Lumps, irregularity or asymmetry
• Infection, and rarely delayed inflammatory nodules
• Temporary result requiring repeat treatment
• Higher risk in noses that have had previous surgery

Where you would be seen

Assessment and treatment are available at CLNQ Manchester at Deansgate Square in the city centre, and at CLNQ Knutsford on King Street in Cheshire — convenient for patients across Greater Manchester, Altrincham, Hale, Wilmslow, Alderley Edge and Macclesfield.

Both sites hold hyaluronidase on the premises with a written protocol for its use, which is the relevant question to ask any clinic offering filler. Complications arising from treatment performed elsewhere in the North West are also assessed here.

• CLNQ Manchester — Deansgate Square 11 Owen Street, Manchester M15 4YB Ground floor of the South Tower at Deansgate Square, Manchester city centre.
• CLNQ Knutsford — Cheshire 49-51 King Street, Knutsford WA16 6DX King Street, Knutsford, serving Cheshire and the surrounding area.

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