By Grace Gold

When we first covered the topic of ethnic rhinoplasty, the tale of Los Angeles high school senior and Persian princess Dornaz Maraghehchi, who received a nose job as a gift for the Persian New Year, stirred much controversy.

Now an increase in the number of Asian patients seeking nose reshaping is bringing the hot topic back into the spotlight.

Ethnic rhinoplasty can be a heated point of contention between patients who say they want a more symmetrically balanced feature and opponents who claim the practice is a Westernized assault on the distinctions that make different races unique.

Yet, a nonsurgical technique that subtly brings features into greater symmetry without changing the character of the shape of the nose is currently gaining popularity amongst minority Asian communities.

The 15-minute procedure, referred to as “injection rhinoplasty,” involves small, strategic injections of either a temporary or permanent filler into the nose to fix bumps, droopy tips, crooked shapes, and flat bridges.

L.A. plastic surgeon Alexander Rivkin performs the procedure frequently and says his practice has recently seen a surge in Asian patients – the majority of whom want to build up the bridge of their nose. Dr. Rivkin sees about four or five patients a day, who are often of Chinese, Filipino, and Korean heritage.

“The most important thing is I’m not trying to give these guys Barbie noses. I want to lift the bridge but not change the ethnicity,” Dr. Rivkin tells StyleList. “Lifting the bridge brings the nose more into symmetry with the rest of the face. It also takes focus away from the tip, making it look less rounded and ball-like. Also, having a bridge means glasses don’t rest on the cheeks, but on the nose – a surprisingly common concern.”

Patients can choose from temporary Radiesse injections, which last between 10 to 12 months and cost about $1,000, or a more permanent option like Artefill, which was approved by the FDA in 2007. The $2,000 injectable is made of methyl methacrylate – a type of plastic housed in a bovine collagen shell that is not rejected by the body and has been used for years in surgical implants.

Skin is first prepped with a topical numbing cream or a lidocaine injection to the more sensitive tip area. Dr. Rivkin also has his assistant tap the patient’s shoulder during the injections, which helps scramble and distract the nerve’s reaction to a needle prodding around the face.

Many patients first opt for a temporary injection to see if they like the results, then make a permanent commitment if they do. With either route, results have to be built up slowly, often over the course of a few visits.

Christine, a 23-year-old Burmese patient who saw Dr. Rivkin for the injectable rhinoplasty, admitted it was glossy images that made her self-conscious of her wider nose as a little girl.

“I liked to read and look through the pictures in beauty magazines,” Christine tells StyleList. “The beautiful women with Western features always were on covers and graced the pages, which started to make me feel different and insecure.”

Christine made an appointment for an injection rhinoplasty with the support of her mother, but didn’t tell her father. She first opted for the temporary filler that lasted a year and slowly built the bridge back up with permanent filler as the Radiesse absorbed.
“Honestly, my friends and family can’t even tell, but I can. They just assume I got a new hair cut or lost weight,” says Christine.

Even though injection rhinoplasty can seemingly alter noses to instant symmetry, there are limits to what a qualified plastic surgeon can accomplish with just injections alone.

“I can’t make a big nose shrink. I can only make a bumpy nose look smaller by making it straight and blending it into the rest of the face,” says Dr. Rivkin. “I’m also limited with what I can do with a large, round tip. Enhancing the bridge will make the tip look smaller, but I can’t shrink the actual tip.”

Yet, the surgeon has had success slightly narrowing round tips, which he says is a common request from Asian patients. Using the injectable steroid kenalog — which is often used to inject pimples – Dr. Rivkin has been able to shrink the tissue of the tip over time.

“Usually, the effects are permanent because I’m reducing the scar tissue inside the tip of the nose,” says Dr. Rivkin.

Complications for the low-risk procedure aren’t common and usually consist of temporary bruising and redness to the injection site, which subsides within a week.

Sometimes, a health benefit may actually result as a side effect. “Rarely, injecting the bridge pushes the skin over, stenting open a tight nasal passage for easier breathing,” says Dr. Rivkin.

But before you ring up your insurance company about your sudden breathing problem, know that the procedure is considered completely cosmetic, and won’t be covered by insurance.