HOUSTON – A nose job without the knife and no recovery downtime? There is a new way to change the shape of your nose without having to go through surgery. A “liquid nose job” is growing in popularity because of the ease and affordability so we wanted to see how it works.

“I have such a heavy insecurity about the beak I have,” said Valerie Espinoza. “I have this hump on my nose, it’s my side profile that I can’t stand.”

For as long as 23-year-old Valerie Espinoza can remember, she has worried about the look of her nose.

“Since I was younger maybe even elementary, I’ve been like, ‘I need to get this fixed,’” she said. “I want it to look more proportional with my face, not so sticking out.”

She didn’t want to go through painful surgery and recovery that could take weeks. Facial plastic surgeon Dr. Sanaz Harirchian said Espinoza is a great candidate for the liquid nose job.

“Liquid rhinoplasty is really good for camouflaging humps, building up a ridge, lifting a tip, adding hight to a bridge, filling little irregularity,” said Harirchian from My Houston Surgeons.

In the procedure, doctors inject fillers into certain areas of the nose to change the shape.

“It’s really the ultimate optical illusion in this procedure,” Harirchian said. “There is no downtime and they can walk in and leave the office 15 minutes later and have a new nose, feel more confident in their skin.”

Would a liquid nose job work for me?

You might not be the right candidate for a liquid nose job if your main complaint is the width of your nose. Fillers would not work to camouflage that complaint. For Espinoza, Harirchian did a consultation to see if this procedure would work for her.

“I’m ready to do this,” said an excited Espinoza.

Harirchian decided to also add a little filler to her chin.

“It’s all about balance,” Harirchian said.

The results

The results of the liquid nose job equal a noticeable difference in the way Espinoza looks.

“Oh my gosh! I’m shaking right now. It looks good! I love it!” said Espinoza. “I would rather take this procedure. If you do an actual rhinoplasty, there is downtime. This is just a quick fix and you can see results right away.”

Espinoza said the procedure is practically painless.

“There was just some minor pinching so nothing extreme,” she said. “They put numbing cream on before so you really didn’t feel anything.”

Harirchian said the results last about 12 to 18 months.

“I have patients who come in every year or every few years for (a) touchup,” the doctor said. “A little bit lasts, so you can keep building on that, so I see patients year after year and every time it keeps getting better and better.”

How much does it cost?

Depending on where you go, it will cost you about $1,000. Also, you don’t want to go to just anyone who does fillers. Because of the delicate areas on the face, you need someone who is experienced.

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was scrolling through TikTok, you know, as one does after a long day of WFH, when I stumbled upon a video that looked like a nose job. But it wasn’t like any regular nose job—the doctor was using what seemed to be legit sorcery to reshape and resize his patient’s nose. “WTF is this?” I texted my friend who always finds herself in a plastic surgery TikTok hole. “Whoa,” she said. “No idea.”

After doing a quick Google search, I discovered that it wasn’t actually magic that transformed the patient’s nose (shocking, I know)—it was a new technique called an ultrasonic rhinoplasty. So to learn more about the procedure, I reached out two board-certified plastic surgeons: (1) Dr. Samuel Lin, who says he chooses not to use this method and why, along with (2) Dr. Kim Patrick Murray, the doctor from the TikTok video I saw, who says he’s never going back to traditional rhinoplasty ever again.

With traditional rhinoplasty, doctors use hammers and chisels to reshape your nose (yup, really). But the ultrasonic method involves reshaping the nose with an ultrasound device that “makes cuts in the bone,” says Dr. Lin. As you can see in the video above, the doctor uses a hand piece—it’s called a piezotome—that transfers a vibration to the nose, says Dr. Kim Patrick Murray. Because the vibration is happening so fast, you don’t even really see it, which is why it’s called ultrasonic.

That vibration is tuned in at a very specific frequency so that it selectively acts on bones and nothing else. So if you put it against skin or a tissue or a blood vessel, says Dr. Kim Patrick Murray, the frequency isn’t high enough to cause any damage. It’s kind of like a car radio when you’re driving in the middle of nowhere—unless you’re tuned in at the right wavelength, there’s no audible sound, just white noise.

FYI: Dr. Kim Patrick Murray says the actual technology used in ultrasonic rhinoplasties isn’t anything new. It was first used in brain surgery to help doctors operate on skulls and faces while trying to protect the surrounding nerves and tissues. But it only recently trickled down to rhinoplasty, he says, when the tools and attachments became small enough to use on the nose.

Why haven’t I heard about it before?

Well, it’s pretty new. In fact, Dr. Kim Patrick Murray only heard about it being used in rhinoplasty about five years ago—and he says it probably wasn’t until two or three years ago when the tools became more available to surgeons in the US. Other than himself, Dr. Kim Patrick Murray only knows of of fewer than five surgeons who perform ultrasonic rhinoplasties here in the States. He says part of the reason why this number is so small is because a lot of surgeons “get into a comfort zone of doing things a certain way,” and that a lot of people are just comfortable using the traditional technique.

However, Dr. Lin says that one of the reasons ultrasonic nose jobs aren’t commonly used at this point is because some surgeons believe there’s a greater chance of post-surgical swelling with the tool—and it’s why he personally isn’t 100 percent sold on the procedure.

What are the benefits of ultrasonic rhinoplasty?

With regular nose jobs, you have to use a chisel and tap at the bone, which breaks open blood vessels, causing lots of bleeding, swelling, and bruising, says Dr. Kim Patrick Murray, so all of that squishy tissue around your nose is being injured. But with ultrasonic rhinoplasty, the frequency of the machine actually protects that surrounding tissue.

“There’s no bleeding, so there’s very little chance of bruising,” says Dr. Patrick Murray. “If you use a less traumatic technique, the recovery is going to be faster.” You’ll still have stitches and need to wear a cast for about a week, but once it’s removed, you shouldn’t have nearly as much swelling as you would with a traditional nose job.

There’s also the added benefit that you can be way more precise with the ultrasonic method, says Dr. Patrick Murray. “Think of an ice pick—when you hit a chisel into a bone and it splinters, it can shatter in a way that you’re not expecting,” he says. He also adds that with a chisel, you’re not able to get the shape of a bone perfectly smooth, kind of like trying to get the perfect nail shape using only nail clippers instead of an electric nail file. “With the piezotome, I can re-contour and resurface the bone in a super precise and three-dimensional way,” he says.

Even though he isn’t only using the piezotome during the procedure (there are other tools involved to manipulate the cartilage and cut into the skin), Dr. Kim Patrick Murray still believes the results are more consistent, the precision is much higher, and the chance of needing a revision goes way down with the ultrasonic approach.

But, it’s important to note that not all doctors agree, especially surrounding relatively new innovations. Like I mentioned before, Dr. Lin believes that patient swelling actually increases with the pietzotome device because the “amount of soft tissue work is greater.” So at the end of the day, it’s best to chat through your options with a surgeon (or two!) you trust before making any decisions.

Who’s a good candidate for ultrasonic rhinoplasty?

According to Dr. Kim Patrick Murray, everyone. “I use ultrasonic rhinoplasty on pretty much every single patient,” he says. Since it’s an elective surgery, you have to be healthy and have no major medical issues (like bad lung function), but besides that, it’s pretty much in anyone’s reach who can afford it.

Is it more expensive than a traditional rhinoplasty?

It’s not that easy to compare. You see, nose jobs are like snowflakes—each one is different. So the cost not only depends on where you live and what doctor you choose, but also how complex the change is, how long the surgery will take, and what materials are needed, which makes Dr. Kim Patrick Murray hesitant to give a range. But according to the American Society of Plastic surgeons, a traditional nose job will cost you around $5,500 and up, so you can use that number as a rough guesstimate.

Another thing to consider: Dr. Lin says the piezotome device isn’t cheap (which is part of the reason why it hasn’t gained a ton of traction in the US), and some of that cost might be transferred to you, the patient.

So, what’s the final verdict?

Well, at the end of the day, it’s really up to you. Both techniques, traditional and ultrasonic, will take you to the same destination using different routes. According to Dr. Kim Patrick Murray, ultrasonic rhinoplasty is more precise and requires less recovery time, while other surgeons, like Dr. Lin, prefer the tried-and-tested traditional method. My advice? Do as much research as possible and chat with your plastic surgeon to figure out what’s best for you.

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A woman who had her first rhinoplasty when she was just 14 years old has regained her confidence after having a fifth surgery to fix her misshapen ‘pig‘s nose.‘ 

Erika from Austin, , appeared on Monday night‘s episode of the E! reality series to meet with Dr. Paul Nassif and Dr. Terry Dubrow as a last-ditch effort to get the nose of her dreams.  

‘My nose looks bulky, nice and wide, and you can see my nostrils — and I have a huge scar on my left side,‘ she explained in her testimonial. 

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Erika said that she works at her family‘s restaurant and customers would actually come up to her and say her nose ‘looks ugly‘ or ask why she ‘that scar.‘  

‘I wanna have pork on my menu, in my restaurant, not on my face,‘ she griped. 

She said she never noticed her nose when she was a little girl, but that all changed when her cousin asked her, ‘Why do you have a pig‘s nose?‘ 

For her ‘sweet 15,‘ she asked her father for a nose job, and while he thought she was ‘crazy,‘ he eventually relented.  

Erika was only 14 when her father found her a plastic surgeon in Austin who would perform the surgery. 

‘Fourteen is a little bit too young for a girl to have a rhinoplasty,‘ Dr. Nassif told the camera. ‘The minimal age that I will do it is 15, as long as the girl has finished her growth spurt.‘ 

Two weeks after her surgery, Erika noticed a dent on the right side of her nose. She waited until the summer to go under the knife again for a second surgery. 

After the procedure, there was a dent on the other side of her nose, so her father opted to find her another surgeon in Guadalajara, Mexico. 

A few weeks after her third rhinoplasty, she noticed that ‘something was popping out‘ and a ‘little scar was appearing.‘   

‘We actually called the surgeon and he tried to fix it, but I remember waking up in the middle of the surgery,‘ she recalled. ‘He was actually sewing me up.‘

‘Anesthesia awareness, where you‘re awake and experiencing the surgery, but you‘re paralyzed is one of the most devastating complications in all of anesthesia,‘ Dr. Dubrow explained in his testimonial. ‘It must be avoided at all costs.‘ 

Erika admitted she was too scared to go back to Guadalajara to ask to get her nose fixed for the fifth time.  

‘I have a crooked nose,‘ she told the doctors, noting that she would like it straighter and narrower.  

In the examining room, Dr. Nassif had Erika pinch her nostrils to show how narrow she would like her nose to be and then asked her to speak. 

The exercise proved that making her nose any slimmer would not only give her a nasal voice, but it would also make it more difficult for her to breathe. 

Erika showed the doctor a picture of her mother‘s nose, which is ‘perfect‘ in her eyes. Dr. Nassif finally realized that she wanted her nose to be longer.   

‘I see what you want; however, there‘s not a lot of elasticity and stretch with your skin,‘ he told her. ‘When I lengthen a nose and the skin‘s not great, we can compromise the blood supply to the nose. There‘s a risk that the skin over your nose can die.‘

Erika felt like she was in ‘good hands,‘ and readily agreed to a fifth rhinoplasty.   

‘If you‘re willing to take the risk, I‘m willing to take the risk,‘ he replied. 

Dr. Nassif used rib bone, grafts, and microdermabrasion to reconstruct Erika‘s nose during the surgery, which was a success. 

‘I‘ve been having problems with my nose since I was eight years old. I had four surgeries and I still had a pig‘s nose,‘ she said. ‘So, after all these years, I finally have the nose I deserve. 

‘You know, I feel like I‘m empowered, and I just feel gorgeous. From today on, it‘s going to be a new Erika.‘

The mom was all smiles when she proudly showed off her new nose to her husband David, her son Mathias, and her longtime friend Jeanette.   

‘Thanks to Dr. Nassif, my nose is longer, it‘s more narrow and you can‘t see into,‘ she told the camera. 

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Ear, nose and throat specialist, Dr. Kevin Jensen, will be the first full-time medical provider at the Wasilla offices of Ear, Nose and Throat Specialists of Alaska. Dr. Jensen joined the Valley medical community on June 18 and will be treating patients at his clinic on Seward-Meridian Parkway and at Mat-Su Regional Medical Center.

Jensen, or Dr. J as he prefers to be called, offers a broad spectrum of otolaryngology services, including endoscopic sinus surgery, thyroid surgery, and obstructive sleep apnea surgery. Thanks to his military background, he also has experience in endoscopic Eustachian tube balloon dilation, and is one of the first providers in Alaska to offer this procedure.

“We were able to take this new technology, which doesn’t have its own billing procedure code yet and use it to help our patients,” Jensen said. Many civilian physicians have not yet adopted this technique, he said, because it is too new to be covered by insurance plans.

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The dilation can help those with Eustachian tube dysfunction, including people who have chronic ear infections or retracted ear drums, those with difficulty clearing their ears during altitude changes, and people who have had long-term use of ear tubes.

The procedure is done by pushing an endoscope through the nose into the opening of the Eustachian tube. An inflated balloon is used to fill space which dilates the Eustachian tube for two minutes before it is relaxed and released. Over time this procedure helps relieve symptoms of chronic ear problems such as fluid build-up.

Jensen believes that the FDA will approve the procedure soon so that it can be covered by insurance. For now he offers the service through self-pay.

Early on in his education, Jenson saw himself headed in the direction of Family Medicine. He liked the idea of treating all ages, from senior citizens and adults to children. It was while he was undertaking a rotation in Ear, Nose and Throat (ENT) care in medical school that he realized how drawn he was to surgery, as well. Now he sees how the hands-on nature of being a surgeon is an ideal match for his personality.

“I really was drawn to being able to work with my hands and using techniques with my hands,” he said.

Jensen is currently one of the only Doctors of Osteopathic Medicine in the ENT field of Alaska, a fact that he feels sets him apart from other providers due to the more holistic and whole-body approach to medicine that comes with being a DO.

When his career took off, people began to call him Dr. J after his basketball hero, Julius Erving, and it has since become his preferred title.

“It really rings in my ear when I hear people say Dr. J,” Jenson said.

Jensen began his career in the military, where he received most of his medical education. He served as a US Air Force Flight Surgeon for three years. Jensen was born and raised in New Mexico, but has lived all over the United States. His family has moved so often that each of his six children was born in a different state.

Dr. J completed 14 years of military service and looks forward to transitioning his medical practice to the civilian community. Several years ago he was stationed as an ENT doctor at Elmendorf Air Force Base, which is how he caught the Alaska Bug.

“Hook, line and sinker…then they moved me to Las Vegas against my will,” said Jensen.

Now he looks forward to returning to Alaska and taking part in his favorite outdoor activities with his family.

“We’re all excited about moving back to Alaska and participating in everything that Alaska has to offer in the outdoors and just the prime, quality people.”

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Sinus and ENT specialist Dr. Greg DeSautel has joined Northwest Iowa Ear, Nose & Throat. Dr. DeSautel will join Dr. Josh Espelund and Dr. Daniel Jorgensen in providing comprehensive pediatric and adult care to patients through the Spencer-based practice and six satellite clinic locations.

“We’re pleased to welcome Dr. DeSautel to our practice,” commented Dr. Espelund. “He is an experienced surgeon, previously based in the Sioux Falls, SD region. Dr. DeSautel will be a great addition to our team as we provide healthcare services to patients throughout northwest Iowa and southern Minnesota.”

The professionals of NW Iowa ENT provide a full range of specialty care for all ear, nose and throat concerns and also provide treatment for diseases and disorders of the head and neck.

Dr. DeSautel is looking forward to joining NW Iowa ENT to establish practice in a small community with a family atmosphere. “I am excited to join dedicated providers to help care for the ENT needs of Spencer and the surrounding communities,” stated Dr. DeSautel.

Dr. DeSautel earned his bachelor of science degree in biology from Luther College in Decorah. He
graduated from the University of Iowa College of Medicine, Iowa City, and then completed residencies in
general surgery and otolaryngology at the University of California in Davis, CA. Dr. DeSautel also earned a master of business education from the University of Sioux Falls.

Dr. DeSautel has practiced in the Sioux Falls region since 1997, most recently as an ENT specialist at Sanford Ear, Nose & Throat. In February, Dr. DeSautel was appointed as cabinet secretary for the South Dakota Department of Social Services. He resigned from that position earlier this spring, expressing a desire to return to patient care.

Dr. DeSautel is married with four children, a daughter 26 years old, and three sons, ages 22, 21, and 12 years old. He enjoys spending time with his family at the lake, bike riding and running.

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