A tip with filler enhancement on the dorsum of the nose is to pinch the skin and pull it gently up before injecting. Dr. Bertucci said, "I am still underneath the level of the skin, and I am off the vessels that may be lying on the bone or muscle."
"I also find that useful and that is what I do," Dr. Tremblay said. I try to generate with pinching the correction I am trying to achieve, and inject until I reach the volume I want."
A long-lasting but nonpermanent filler product is more ideal than a permanent one in the nose, Dr. Bertucci said. "This leaves you a way out, and the anatomy changes with age." Hyaluronic acid or calcium hydroxylapatite products are examples. In contrast, use of silicone can be riskier in terms of overcorrection and granulomatous effects.
A meeting attendee countered that he prefers silicone because hyaluronic acid corrections only last 2-3 months in his patients. Dr. Bertucci replied that, because of its permanent nature, "I would not use silicone unless you are very skilled in its use."
Injection-related pain, redness, bleeding, ecchymosis, and hematoma are possible complications regardless of the product type injected, Dr. Bertucci said.
Dr. Bertucci disclosed that he is a consultant for Allergan, Medicis Pharmaceutical Corp., and Merz Pharmaceutical, and an investigator for Allergen and Merz. Dr. Tromblay disclosed that he is a medical consultant for Allergan, Medicis, Canderm Pharma Inc., La Roche-Posay, Procter & Gamble, and Johnson & Johnson.