What Exactly Is the Liquid Rhinoplasty? And Would It Work for Me?

Vogue

5 days ago

Last fall, after decades of vision so poor I couldn't recognize my closest friends across a small room without glasses, I paid $10,000 for ICL surgery, a newish LASIK alternative in which permanent contact lenses are installed in one's eyeballs. Besides the somewhat daunting, monthlong course of prescription eye drops that followed, recovery was swift. I've had no major medical complications, only subtle psychological ones: Improving my vision, I realized, impaired the way I saw myself.
For the first time in as long as I could remember, I looked in the mirror and saw only my face staring back at me. No brow-hiding frames, no eye-distorting lenses. And most crucially, perhaps, was my nose: bare, no longer horizontally bifurcated by a ridge of black acetate.
In a good mood, on a good day, my nose is 'striking' or 'distinguished.' It has 'character,' to quote my mother. In a bad mood, on a bad day, it is simply crooked. 'I'm so glad she never fixed it,' a famous artist recently told a mutual friend, upon meeting me. Meant as a compliment, I, of course, interpreted it as insult.
Should I have fixed it? A basketball to the face in middle school left a hairline fracture and with it a slight asymmetry I was always aware of without really caring about. But now the asymmetry shone (sometimes, especially in photographs, literally: reflecting a spot of glare back at the camera). My friends and family all called me crazy whenever I mentioned it, but their reassurances were of little value. It wasn't that I didn't believe them—I didn't care what they looked like either!—but I wanted a professional opinion.
One drizzly spring morning, I entered the sprawling, multi­story Park Avenue office of plastic surgeon Lara Devgan, MD, whose Instagram follower count approaches 1 million and whose proprietary skin-care fans include Kim Kardashian and Jennifer Aniston. Known for what she calls 'facial optimization,' Devgan tends toward an approach made up of 'tweaks,' as she refers to them—the facial equivalent of having an old dress tailored rather than getting a fabulous new one custom-made.
'So you have a 'deep radix,' ' she said, petting the depression at the top of my nose with her index finger. There was also, she went on, a 'widening of the dorsal nasal aesthetic lines': the bridge, in lay terms. There was 'some crookedness,' which she said was 'likely the site of prior trauma.' Lastly, I suffered from what she described as 'a little bit of a bulbous and slightly droopy nasal tip.'
Finally, some honesty, I thought to myself.
A good, old-fashioned rhinoplasty could, of course, make my nose smaller and less crooked. It would also cost close to $20,000, require general anesthesia, take up to a full year to see the final results, and turn me into a person who got a purely elective nose job at an age (37) that was, in my opinion, decades past the point of utility.
But there were other methods. 'One of the hallmarks of modern plastic surgery is customizability,' Devgan said. Some well-placed injections of hyaluronic acid—which functions almost like a cartilage graft—at the top of the nose (to lessen the prominence of the bump) might 'optimize' my appearance, as she put it. 'We don't have to have you look textbook to be happy.'
Devgan was describing, essentially, a nonsurgical nose job—or a 'liquid rhinoplasty'—a procedure that has been growing in popularity without being, in itself, new. (The practice of injecting the nose with various liquids dates back to the turn of the 20th century, when precarious substances including oils and waxes were used.) The first filler made of hyaluronic acid—which is also used topically for its moisturizing properties—was approved for cosmetic use by the FDA in 2003, and in the years since its effects can be seen everywhere from the enviably sculpted cheekbones of influencers to the trout-y mouths of the ladies populating Bravo and so many of the women who love to hate them.