The Nose Filler Divide

what to make of the latest social clash

In 2021, I reported on the nonsurgical nose job, investigating its purported fall from favor. At the time, some doctors were claiming that patients had grown disenchanted with the procedure. Others argued that it was more in-demand than ever. Years later, experts are still debating the merits of liquid rhinoplasty. Have you seen the recent back-and-forth on social? It started with board-certified dermatologist Shereene Idriss, MD, referring to nose filler as “the biggest cosmetic mistake” one can make and outlining all the ways it can go wrong. Proponents of the procedure quickly fired back, defending its safety profile and satisfaction rate.

shereeneidriss

A post shared by @shereeneidriss

I’m not taking sides. FWIW, I think both POVs are valid: Yes, the nose is a danger zone for filler—the vessels of the nose share connections with those supplying the eyes, and blocking them can cause blindness—but that doesn’t mean the nose can’t be safely injected by someone who knows what they’re doing. As with every procedure, risk is largely determined by the skill, experience, and judgment of the practitioner.

What I wish the experts would have disclosed is that no part of the face is 100% safe from filler complications. Vision loss has been reported with filler and fat injections to not only the nose, but also the glabella, forehead, under eyes, lips, cheeks, temples, chin, nasolabial folds, earlobes, you name it.

Aesthetic Surgery Journal, 2024

Blindness is a rare complication, certainly, but let’s not be lulled into a false sense of security by posts that condemn one filler treatment while failing to acknowledge the risks inherent in others. Injectables, while generally safe in expert hands, are not always as breezy as they seem. I’m sure you’ve heard the tragic story of Esther Jeong, the ceramic artist who got a “skin booster” in Korea, believing it to be a “very harmless” treatment, and wound up blind in her left eye. (I find the marketing of these products to be egregiously misleading, but that’s a topic for another day.)

Since my 2021 article has disappeared from the internet, I’m including parts of it here. I won’t rehash the debate over the popularity of nose filler, but I do want to highlight the pros and cons of the procedure and fact-check the risks.