Okay, so here we go. We are live talking about, um, non-surgical rhino here with Alan.

Alan:

Hi guys.

Dr. Shah:

Okay, so Alan, uh, what are our goals today?

Alan:

I’m trying to, ever since I was a kid, I was always self-conscious about this little broken hump that I have over here. So what I’m trying to do is kind of create more of a symmetrical look as well as kind of fixing this little hump that I have.

Dr. Shah:

Okay. So if we’re kind of look around, we can pan around through here. So what we’re gonna be doing is, um, actually I don’t have as much of a problem what Alan’s nose as Allen does, but this is the part, this is the radix, this is the top part of the nose. So what I’m gonna be doing is gonna be adding filler here. So I’m doing what’s called a nonsurgical rhinoplasty, and Alan, I think is a decent candidate for that.

So when I add filler, the goal is to make this transition smoother. We’re gonna pan around to the front of Alan and if you look to the front, we can all kind of go together. Um, you’re gonna see that his nose isn’t perfectly straight. So one of the limitations of filler and nonsurgical, um, rhinoplasty is it’s very hard to make a nose that’s not straight straight. The best patients who are candidates for this are typically gonna be East Asian patients, uh, who want to add volume to the grid. Some African American patients, uh, but typically patients who are, um, wanting their nose smaller, this doesn’t work. All non-surgical rhinoplasties you’re gonna do, you’re gonna be adding to the nose. So you’re making the nose bigger. But we’re trying to give it the evolution of being straighter and smoother. Um, the number one risk, if you’re doing this, Alan already knows this is blindness.

The blindness. So you always do this with a little bit of a calculated risk. The risk in is about one in 500,000 patients. Um, when you inject your <inaudible> anywhere in the face, you have to be worried about that. So that’s one of those concerns that we’re gonna be in there saying, Hey, we don’t want to have that happen. There’s a few steps you can do to kind of mitigate that and hopefully prevent that. I’ve never seen that in one of my patients or anyone else, but it definitely can happen. Um, so that is definitely a risk that we’re gonna be looking at. Um, and so we’re gonna be adding that to Allen’s nose. Um, if feel, the notes seems to last longer, how long Allen, do you think when you’re injecting patients? How long do you think it last in so much, like nasal folds?

Alan:
It depends on mean. It depends on the failure, but it could be around a year or so, or maybe longer.

Dr. Shah:

Sometimes two years. Um, and I think for me, I get my own face. It last like not that long at all. I think it maybe I smile a lot or maybe it’s my angry expression. Could I get like three months and fill out my, my smile lines? Um, and so in the nose though, because there’s not a lot of movement here, um, we have a little muscle up in here. Uh, so we have kind of part of our proces going through here. Here’s our corrugator muscle, that proces muscle. Um, there’s not a lot of movement here, so since there’s not a lot of movement there, uh, the fill tends to stay longer. I’ve seen patients where I’ve operated on them and um, they may have had filler done six or seven years ago and I still see filler, not like filler, turning into collagen, actual filler in the nose.

So it does last a lot longer in the nose tends to, will last longer in the eyes as well. So it’s kind of a cool thing here. So what we’re gonna do is we’re gonna add the volume in for a, um, and then we’ll see, um, it’s one of those things kind of going into there. Um, I think there’s probably fewer candidates for nonsurgical rhinoplasty than they are for surgical rhinoplasty. Both have risks associated with it. Uh, both are kind of technical. Um, I can do more with the surgical rhinoplasty, but the benefit of this is Alan can do this, he can enjoy his weekend. Um, and then kind of other things that you wanna be aware of. Uh, you wear glasses, Alan?

Alan:

Mm-hmm. <affirmative>, but not, not all the time. I mean right now I just wear contact most of the time so I won’t put any, um, like at night.

Dr. Shah:
Yeah, if you’re gonna wear them, you might wanna wear them like, um, like granny style, um, which is kind of like lower on the bridge away from the filler. So you can do that in the beginning if you do. I didn’t know you wear glasses, so I do <laugh>. You learn something new every day. That’s right. Um, and so that would be one of those things to be aware of. 70 sunglasses as well. Uh, you want, don’t wanna put pressure on the nose. And then if I’m doing someone’s whole nose, it’s gonna look a little thinner because that’s fill, it’s filler we’re putting in there, it’s gonna want to spread. Um, my filler of choice, there’s a couple fillers that are out there. Um, but my filler choice is this product, Voluma and Volux is um, kind of my favorite product that kind of put out in there.

Uh, there’s another product that just came out that’s kind of like dilemma, but even thicker. Uh, do you like that product? Volux?

Alan:
I do. Um, I do it for male enhancement and I use it for jaw. Um, it’s incredible. It’s a really nice and sweet product.

Dr. Shah:
What’s male enhancement? Tell me Audience <laugh>.

Alan:
So male enhancement, we essentially, um, enhance uh, a penis with filler, um, to increase Garth and resting length and even sometimes directly. So, um, those are something that’s something that we can definitely do with the filler and it’s much more of a preferable method than a lot of other methods, especially surgical methods out there as well as fat transfer. Um, cuz they’re not as reliable as filler, I would definitely say. And they cause a lot more complications.

Dr. Shah:

Okay, well we’re gonna be doing, um, a different, uh, single appendage, the nose <laugh>. So here we go. Um, so before you do anything with the nose, um, what I’d like to do is, first we’re gonna wipe this a few times. Um, volu lasts a long time in notes like we talked about. So I almost plan on this being like a surgical procedure. So I’m gonna first do alcohol and then the second thing we’re gonna do is we’re going to use, which sounds like a, uh, a birth control perx.

What does perx sound like to you?

I don’t know. <laugh>,

Do you have any other thoughts? Does not sound like it’s to, it generalizes you. Mm-hmm. <affirmative> your skin. Generalizes your, not your ovaries. <laugh>, <laugh>. Here we go. You’re gonna hold that for me for one second. Here we go. I like flirting loops when I do lots of things just because I think it’s just easier to see that if we kind of come in from the front. Again. We’re gonna see that there is some deviation through here. So we’re gonna be working with straightening a’s nose, but really it’s gonna be on that profile view. You’re gonna put your head back, all me, and then you can turn your head towards me. Any questions out there in virtual reality? Maam, I’m gonna have you hold this up for Christina.

Notice I’m tempting <affirmative>. How long have you object to me Check with your, what part of your thumb?

One big tissue or just in general? Push then syringe you mean? Oh, with the right. Definitely righty. Or to use the, uh, the tip of your thumb or the, the mallet of your finger. Or you have, you do it so much you can’t even think about it. I do it so much that I don’t think about it, but I think typically more of, um, I would definitely see the mallet maybe to too. So quickly. That’s the same thing you do when you just fire a gun. Hmm. The only gun I’ve ever fired was on a Nintendo 64. Does that count? <laugh>, I guess sounds accurate, but I didn’t actually try to kill the characters on there. Just trying to scare them.

Someone did say they feel like this would be the most painful location. So what do you think? A painful,

Honestly, no, it really isn’t painful at all. Like I’m, I didn’t even put any type numbing on myself in them. Yeah, we do. Yeah. No numbing and I’m, I’m just, yeah, he’s chilling.

Dr. Shah:
And what they don’t know is, before we did this, we hopped Ellen up with a bunch of, uh, sentinel notes. <laugh> design. Okay. So I actually used on you as one full cc and if you look in here, I’ve used point, you can zoom in on that. Uh, 0.25 ccs of fill. Let’s see where Alan’s at. Again, I tend to be conservative with everything. We’re gonna look at Alan’s notes from the side and from the front. Christine, I’ll give you that. Perfect. I’ll thank you too. And so let’s look at his notes from the side so we can see that now we’ll look on the other side too.

And so straighter through here. And we can kind of pan around through the front. So if we’re looking through here, um, we kind of wanted to add into the spot again, it’s gonna look a little, a little narrower just because we added that filler in his nasal bone. Had a little depression there, so I added just a bit through there. And then the goal over here is just to kind of create that straighter profile. Yeah, it looks a little swollen right now. Put it straight. All right. Ellen, how do you feel? Someone said results so quick. Honestly, I feel great. Like it doesn’t feel bad at all. Okay. So you haven’t seen yourself yet, have you? No, I haven’t. Oh my goodness. Okay, so here we go. It’s so good. Let’s take a look. You can hold that. Oh my God. That’s like, it’s just so crazy.

Alan:
That’s awesome. That looks really cool. I like, I’ve always wanted to straighten it out a little bit and now the fact that it, it is straight, it’s like, whoa, <laugh>. I like it. It looks good. Thank you.

Dr. Shah:
Yeah, fun stuff here. So, um, just do a little bit of fill through there. And then the cool thing about this is for some reason if Alan didn’t like this, we could reverse it. It’s a nice preview for some patients in doing things. And how many fingers am I holding up? Allen? Am I supposed to look at you? Yeah. <laugh> three, four. Okay. Sorry. <laugh>. That joke never gets old. <laugh>. Yeah, I’ve seen all that. I’ve seen everything. So again, if he was, if he were to be blind, it would happen right away. And so we can kind of put that off. Even though it’s a low risk, it’s still one of those risks we look at. Mm-hmm. <affirmative>. Okay. All good. Awesome. Thanks for joining us. Happy Friday. Bye guys. Oh my gosh.