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Commonly referred to as a "non-surgical rhinoplasty" or a "liquid rhinoplasty," hyaluronic acid filler such as Restylane© products are often placed in the nose to achieve an aesthetic goal. However, this procedure is not appropriate for everyone and has specific limitations that people should be aware of. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. This 24-year-old came to Dr. Harmon with a desire smooth the bump on her nasal bridge in a natural way and without surgery. Hyaluronic acid filler was added to the bridge of her nose above the bump in order to accomplish this. Placing Filler in the Nose Always Adds, Never Subtracts Placing filler in the deep tissue of the nose is always additive by definition and never a reductive procedure. This limits what can be accomplished when compared with nose surgery (rhinoplasty), which can be customized to address a wide variety of major and minor aesthetic concerns. The Treatment is Temporary Placing filler is also temporary. Hyaluronic acid filler typically lasts approximately 1 to 1.5 years, though it can last for less or more time in some instances. As a result, this procedure requires ongoing maintenance treatments to maintain the same effect. The Treatment is a FDA Off-Label Use of Hyaluronic Acid Filler It is important to note that treatment of the nose with hyaluronic acid filler is an FDA off-label use of these products. However, hyaluronic acid filler has been used in the nose for many years by well-trained, experienced, qualified medical professionals. Little-to-No Down Time It is, however, an in-office non-surgical procedure with little-to-no down time and no required anesthesia. Those are major benefits. A Liquid Rhinoplasty Can Effectively Address Two Concerns About the Nose Hyaluronic acid filler can be effective in improving a large, peaked nasal bridge by adding volume to the top of the bridge, thereby softening the curve of the nose. Filler can also be effective in creating the appearance of a lifted nasal tip in some individuals. However, a history of previous nose surgery (rhinoplasty) may preclude the placement of filler in the nasal tip due to concerns about the blood supply to the nasal tip after surgery. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified, fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us today to learn more! Contact Us

Patients have increasingly sought treatment of the corner of the jawline with products such as Botox© for cosmetic and functional purposes. The muscles treated are called the masseter muscles. This blog post seeks to clarify what the masseter muscles are, what cosmetic and/or functional concerns they can contribute to, and how treatment with products such as Botox© may benefit these cosmetic and/or functional concerns. My expertise as an aesthetic facial plastic surgeon is in addressing cosmetic concerns with the masseter muscles. Any functional improvements are wonderful potential secondary benefits. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck to determine whether treatment of your jawline with Botox© is right for you. The Masseter Muscles Are for Chewing The masseter muscles are large, strong muscles that sit on either side of the back corner of the jawline. They are one of multiple muscles that contribute to chewing. Tension in this muscle can contribute to jaw pain as well as teeth grinding at night, also known as bruxism. Large masseter muscles can contribute to fullness in the back of the jawline, resulting in the appearance of a wide jawline, which can be an aesthetic concern, especially in women. Treatment of the Masseter Muscles with Botox© Can Benefit a Patient Aesthetically Products such as Botox© are injected into the lower part of the masseter muscles, which attaches at the back and bottom corner of the jawline. Botox© is injected into the deep muscle to be effective while still preserving strong chewing function. The purpose of this treatment is to reduce the size of the masseter muscle by reducing its strong contraction. The overall aesthetic effect that can be achieved is a reduction in the width of the jawline. Treatment of the Masseter Muscles with Botox© Can Benefit a Patient Functionally Products such as Botox© are frequently placed in the same location in the masseter muscles to treat tightness in the jaw as well as bruxism. Patients seeking treatment of enlarged masseter muscles often mention the above concerns as well. And, while the primary purpose of placing Botox© in the masseter muscles at Harmon Facial Plastic surgery is for aesthetic purposes, any potential functional benefit is welcomed. Patient often return to clinic excited because their jaw symptoms improve after treatment. Treatment of the Masseter Muscles with Botox© is Safe and Effective but an FDA Off-Label Use It is important to note that injection of the masseter muscles with Botox© or other similar products is an FDA off-label use of these medications. However, there are multiple locations in which these medications have been used FDA off-label for many years safely and effectively. For example, Botox© was FDA approved for use in the forehead in 2017 but had been used safely and effectively in this location for many years prior to its approval. It is important to have a conversation about this with your facial plastic surgeon. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching "plastic surgery near me." Get in touch with us to learn more. Contact Us

Filler migration involves the movement of injected filler (e.g., hyaluronic acid filler) away from the location in which it was initially injected. This is a very rare occurrence in skilled, experienced hands. There are various reasons why filler migration may occur. All are based on conjecture. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon who has extensive experience with injectable procedures to minimize the risk of filler migration. Filler Migration Can Occur Anywhere but is More Noticeable in Specific Locations Filler migration can occur anywhere. However, it tends to be noticed more in specific locations such as the lips and the tear troughs. Physical Signs of Filler Migration The sign of filler migration is new volume in an area where it was not previously injected with filler. The changed contours can distort or eliminate the natural transition points from one anatomic region to another. It is important to note, however, that swelling is normal after the injection of hyaluronic acid filler. Furthermore, this swelling can develop outside the area injected. Swelling tends to resolve after a few days but up to approximately two weeks. It rarely lasts longer than two weeks. The Product Used, Total Volume Injected, and the Depth of Injection All Likely Affect the Risk of Migration Too much product injected too superficially may be the primary reasons why filler migration occurs, though this is not proven in the medical literature. Furthermore, there is no "threshold" volume in one location over which filler migration is likely to occur. However, it stands to reason that the more mobile superficial tissue planes can push filler in locations it was not initially injected. This becomes more likely the more volume is added. Every patient is different and, therefore, can tolerate a specific volume before being overdone. It is important, however, to avoid layering too much filler, especially different products, prior to the previously injected filler dissolving adequately. This can result in the gradual accumulation of too much filler that then migrates. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face when you have concerns about your face. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us to learn more! Contact Us

The following blog post is a quick summary of the few things that are okay and need to be avoided after treatment of the face with Botox©. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Avoid Massaging Your Face and Exercise for a Day It is best to avoid massaging your face or exercising for one to two days after treatment. This reduces the risk of the medication diffusing to areas of the face where it was not originally placed. It is Okay to Wash Your Face and Apply Makeup Afterwards However, it is okay to wash your face and apply makeup after treatment. It is normal to have small red dots in a few areas of the face where the medication is administered. And while the skin is gently cleaned before and after treatment these red dots often persist until washed with soap and water at home. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us to learn more! Contact Us

The differences between hyaluronic acid naturally present in the body, that is applied to the skin in skincare products, and that is injected as filler (e.g., Restylane©) is whether the hyaluronic acid is formulated in the body or the lab and whether the hyaluronic acid is cross-linked or not. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Hyaluronic Acid is Naturally Present in the Body Turned Over Quickly Hyaluronic acid is produced extensively in the body. It is broken down by natural enzymes in the body within 24 to 36 hours of being produced. Hyaluronic acid retains water well. It also acts as a shock absorber within the support matrix for skin cells. Hyaluronic Acid Applied to the Skin Needs to be Absorbed to be Effective Hyaluronic acid is excellent at retaining moisture. The term for this is a humectant. In fact, hyaluronic acid can retain 1,000 times its weight in water. That is why it is included in many skin moisturizers on the market. However, the lab-formulated hyaluronic acid molecules need to be small enough to be absorbed by the skin to be effective. Many products are ineffective because they are not small enough to be absorbed. Topical hyaluronic acid that is not completely absorbed by the skin will draw moisture out of the skin to itself. This will dry the skin. As a result, hyaluronic acid is probably best used in a humid environment so that moisture moves towards rather than away from the skin. Hyaluronic Acid Filler Injected Under the Skin is Stabilized by Cross-Linking Hyaluronic acid filler, which include Restylane© products, is composed of hyaluronic acid molecules produced in a laboratory which are cross-linked so that they develop certain properties useful for aesthetic purposes but also remain present without being dissolved by the body's natural enzymes as quickly. These products can last in the body for six months or longer; that is, unless a medication called hyaluronidase is injected where it is located. Hyaluronidase is a lab-produced enzyme that can speed up the dissolution of cross-linked hyaluronic acid filler. This filler needs to be injected under the skin because the size of the cross-linked molecules prevents skin from absorbing it. And, because hyaluronic acid filler absorbs water, swelling immediately after injection of hyaluronic acid filler is expected. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us to learn more! Contact Us Reference Baumann L. Cosmeceuticals and Cosmetic Ingredients. McGraw-Hill Education; 2015.

Hyaluronic acid dermal fillers can address specific concerns about flatness or poor volume in your face, including your temples, cheeks, tear troughs, lips, chin, and/or jawline. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon to help determine whether dermal fillers are appropriate for your concerns. Different Hyaluronic Acid Dermal Filler Products Deform and Change Under Stress Differently The study of how a material – in this case, hyaluronic acid dermal filler – deforms and changes under mechanical stress is called rheology (1). Hyaluronic acid is produced in the body in massive quantities but is soon dissolved. In contrast, hyaluronic acid dermal filler products are produced in a laboratory, outside of the human body, with particles of a controlled size, concentration, and extent of crosslinking. Crosslinking is a chemical process that binds these hyaluronic acid particles. It is these qualities that are used to produce dermal filler products with features that are optimized for placement in specific areas of the face to achieve a cosmetic goal. Extent of Crosslinking and Concentration of Hyaluronic Acid Determines Rheology More extensive crosslinking results in a stiffer dermal filler. It also prolongs the effect of the product. A higher gel concentration also results in a stiffer gel. Different products include hyaluronic acid at different concentrations and different levels of crosslinking to produce a desired effect. Rheology Describes Useful Hyaluronic Acid Dermal Filler Qualities The stiffness of a dermal filler, or its ability to return to its original shape when acted on by forces, is called the G'. The higher the G', the stiffer the gel. Each hyaluronic acid product takes a different approach to reach a specific G', with some products focusing more on the extent of the crosslinking while others focusing more on the concentration of hyaluronic acid particles in the gel. For example, softer hyaluronic acid fillers such as Restylane Silk© are often used more superficially or in areas with thinner tissue overlying it, such as the tear troughs, due to its lower G'. In contrast, Restylane Lyft© has a high stiffness, or G'. As a result, it is generally placed deeper and in areas requiring a more pronounced, stable lift, such as the cheeks or temples. The extent of crosslinking and concentration of hyaluronic acid gels also determine the product's cohesivity, which determines whether a product maintains projection or falls apart with pressure, such as massage. A less cohesive product is more malleable and can be massaged in place more easily. Restylane products have the lowest cohesivity of the different brands of hyaluronic acid fillers (2). Trust your face to a facial plastic surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about flatness or poor volume in your face, including your temples, cheeks, tear troughs, lips, chin, and/or jawline. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us to learn more! Contact Us References 1. Heitmiller K, Ring C, Saedi N. Rheologic properties of soft tissue fillers and implications for clinical use. J Cosmet Dermatol. 2021 Jan;20(1):28-34. 2. Sundaram H, Rohrich RJ, Liew S, Sattler G, Talarico S, Trévidic P, Molliard SG. Cohesivity of Hyaluronic Acid Fillers: Development and Clinical Implications of a Novel Assay, Pilot Validation with a Five-Point Grading Scale, and Evaluation of Six U.S. Food and Drug Administration-Approved Fillers. Plast Reconstr Surg. 2015 Oct;136(4):678-686.

Hyaluronic acid filler is commonly placed in the jawline to mask age-related changes to the jawline, including drooping jowls and loosening skin and muscle. However, placing hyaluronic acid filler in this location is not a replacement for a facelift and can sometimes masculinize the face and/or accentuate the appearance of the jowls. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. A Hyaluronic Acid Filler Product for the Jawline was Recently FDA-Approved The hyaluronic acid filler product by Juvederm©, Volux XC, has recently been FDA-approved for use in the jawline. However, there are multiple products from companies including Restylane©, Juvederm©, and others, that demonstrate properties that may make it appropriate for use in the jawline. These products may be appropriate for individuals with a weak, receded jawline, most often in men. Only a Small Cohort of Female Patients Could Potentially Benefit from Jawline Filler Generally, only a small cohort of female patients demonstrate a weakness in the jawline severe enough to benefit from placement of filler in this location. The problem with adding volume along the jawline in women with drooping jowls and a loss of definition of the jawline is that it risks masculinizing the face and making the jowls appear heavier than they are. In contrast, the chin is a commonly recessed area for which filler can often be an appropriate treatment option for men and women. Only a Facelift Can Directly Address Jowls A facelift and neck lift are the best treatment options for loose and drooping soft tissue - including skin, muscle, and fat pads - along the jawline. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us to learn more! Contact Us