Call us at 469-467-0100

Plano TX Plastic Surgery - Flower Mound TX Plastic Surgery

« Back to Blog

Category: Restylane and Juvederm

Nonsurgical Rhinoplasty with Injectable Fillers

I am increasingly using injectable fillers to improve nasal defects that previously required surgery. Use of Juvederm and Restylane has proven valuable in specific types of deformities involving the nasal dorsum (bridge of the nose).

Typical nasal deformities addressed by hyaluronic acid fillers:

  • Saddle nose. A saddle nose occurs when there is reduced support to the middle third of the central nose, causing it to become concave, instead of straight. (Hint: it looks similar to a horse saddle.)       Injection of filler into the concavity can make the nose appear straighter on profile.
Saddlenose correction
Saddlenose before Saddlenose after
Before After


  • Contour irregularities of the nasal bridge caused by prior rhinoplasty (nasal reshaping) surgery. Rhinoplasty surgery sometimes leads to small defects, such as localized areas of flatness or concavity. Injection of facial fillers may correct these small irregularities.


Contour irregularity on bridge of nose
before injection after injection
Before After


  • Nasal deviation caused by prior rhinoplasty surgery. A mildly twisted nose either due to prior rhinoplasty or incompletely corrected by prior nasal surgery can be camouflaged by selective filler injections, making the nose appear straighter.


Keep in mind that Juvederm and Restylane typically last 6 to 12 months, so these are not permanent solutions. However, they can certainly be repeated—and there is generally enough left in the syringe to inject other areas of the face (lips, folds, lines).

While these techniques are not a substitute for secondary rhinoplasty in the case of a large nasal deformity, subtle defects are often more easily, cheaply, and reliably treated by hyaluronic acid injectibles, particularly in patients who are reluctant to undergo yet another rhinoplasty surgery.


For more information about procedures performed, please visit

Ronald M. Friedman, M.D.

Director, West Plano Plastic Surgery Center

Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas

Performing Facial Injections

I am fully aware that Botox and facial fillers are available on practically every street corner. Doctors’ and dentists’ offices, medical spas, and even beauty parlors offer injectables. Patients are routinely injected by gynecologists, dentists, nurses, aestheticians, medical assistants, and occasionally personnel with no formal medical education.  The results of the injections are variable: some are pretty good, and some are awful.

In contrast to the other injectors, plastic surgeons make their living by operating on people, not by injecting them.  I am no exception.  So why do I personally perform every injection?

Botox to glabella

botox injection plano tx


botox injection plano tx


Restylane to the nasiolabial folds

restylane injection plano tx



Because I’m good at it.  With an artistic background as a wood and marble sculptor and a medical background as a plastic surgeon, I feel better qualified to perform Botox and Restylane injections than the nurses and medical assistants in my office.  I understand the anatomy of the facial muscles better than your dermatologist—because I perform surgery on those very same muscles.  I can mark the muscles for injection based on your unique anatomy, rather than using a standardized diagram provided by the medical manufacturers.  I know that Restylane and Juvederm are not interchangeable products, and I understand when to use each.  I did not develop my knowledge through a weekend course at a hotel; instead, I developed it over 17 years as a board-certified plastic surgeon.

If I am the most qualified person in my office to perform injectables, I cannot delegate this duty to anyone else.  I really do care about doing my best for my patients, and I am compulsive about providing consistent, quality results.  Although I could hire an aesthetician or train a nurse injector, I still believe that if you want something done right, you have to do it yourself.

Ronald M. Friedman

Director, West Plano Plastic Surgery Center

Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas

Dr. Friedman prides himself on personally performing every Botox, Dysport, Restylane, and Juvederm injection.  Although ice is suitable for many patients, he believes that it is unfair to charge extra for patient comfort.  So he provides effective topical anesthetics and/or 70% nitrous oxide (laughing gas) at no additional charge.  Our practice serves the Plano, Frisco, Allen, and McKinney communities.

Please visit our website for more before and after Botox and Dysport photos and before and after Restylane and Juvederm photos of patients who have been injected by Dr. Friedman.

Restylane for Saddle Noses

A saddle nose entails a concave or “collapsed” look on nasal profile, resembling the shape of a saddle.  Some people’s noses just happen to look that way.  Other people may develop saddle noses following nasal trauma, infection, or rhinoplasty. Typical treatment for saddle noses is complex.  It generally involves a rhinoplasty (“nose job”) with placement of cartilage grafts taken from the nasal septum, ear, or even a rib. I have found Restylane to be a safe, convenient, and relatively inexpensive alternative to major nasal surgery and grafting in patients with saddle noses.  Restylane is a clear gel that is injected into facial wrinkles and folds to provide better contour and volume.  While it is usually used for the lips and cheeks, it is also beneficial in improving the concave or sunken profile associated with saddle noses.  Restylane involves no surgery, no surgical incisions, and no surgical recovery.  It generally lasts about six months, so there is also no commitment. This means that you can always do a rhinoplasty once the Restylane reabsorbs–but I doubt that you will.

                  Before                                                                        After

                  Before Restylane        After Restylane

                  Before                                                                        After

                  Before Restylane         After Restylane

Saddle nose injection with Restylane

Ronald M. Friedman Director, West Plano Plastic Surgery Center Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas Dr. Friedman is the Founder and Director of the West Plano Plastic Surgery Center on the campus of Presbyterian Hospital of Plano.  He also serves the Frisco, Fairview, Lucas, and Wylie communities.

Sculpture and Surgery: a brief autobiography

Plastic surgeons and cosmetic surgeons routinely advertise that they can “sculpt” your features: your nose, your tummy, even your breasts.  Patients routinely request a “chiseled” jawline. Who would want to have liposuction when you can have liposculpture?


The sad truth, however, is that most surgeons are not actually sculptors.  There are no art classes offered in medical school.  And if your surgeon, by chance, has a background in drawing or painting, these are 2-D activities which poorly translate into the 3-D world of surgery.


Before                                              After


By contrast, I am fortunate to have extensive experience in wood and marble sculpture.  I took shop class in 7th grade when I couldn’t figure out what else to take for an elective—and I fell in love.  Soon I was spending 60-hour weeks in my workshop during high school summers.  It got really exciting when people started buying my sculptures: first neighbors and eventually strangers.  Then I started displaying in shows and galleries.


At some point toward the end of high school, I had to make a decision: pursue art and music (my other major endeavor) or pursue academics.  I decided to pursue medicine, in general, and plastic surgery, in particular.  Plastic surgery was and continues to be the closest that I can come to doing sculpture for a living—and still be able to make a living.  (You’ve heard of starving artists, but you probably haven’t heard of starving plastic surgeons.)


Does this mean that I can sculpt your body?  Not really.  Surgery is not sculpture because the human form is far less predictable than a block of wood or marble.  Unlike any other medium, human tissues are fragile; can become scarred, infected, or bleed; and change contour as they heal.


Does this make my background in sculpture useless?  Of course not. Every day I have to make decisions during surgery.  While some of these simply require a good tape measure or caliper, others require something more elusive: an artistic eye.


I sincerely believe that my background as a wood and marble sculpture has helped me become a better plastic surgeon.


For more information about breast augmentation–including more photos, please visit

Ronald M. Friedman, M.D.

Director, West Plano Plastic Surgery Center

Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas


Juvederm, Restylane, and Perlane Prices in (Frisco, Allen, McKinney, Richardson, Garland, Rockwall, Sherman, Irving, Las Colinas, Lewisville, Highland Village, Denton, Grapevine, Colleyville, and Southlake)

Uses of hyaluronic acid fillers

Juvederm, Restylane, and Perlane are hyaluronic acid (HA) fillers frequently used to fill facial lines, wrinkles, and folds or to add facial soft tissue volume anywhere it is desired.  A list of the top 10 uses for HA fillers is included in a previous blog.

Personalized injection directly by the plastic surgeon

Although these products are frequently injected by nurses and estheticians, I personally perform all injections of HA fillers and botulinum products (Botox and Dysport).  Although these substances are temporary, skillful injection is still important.  I also think that my extensive experience as a wood and marble sculptor is equally helpful in surgical and non-surgical shaping procedures.

Restylane , Perlane, Juvederm prices

We currently charge $540 for the first syringe of any hyaluronic acid filler (Juvederm, Restylane, and Perlane).

We currently charge $490 for each additional syringe.

Laughing gas (nitrous oxide) is available at no additional charge.  There is also no additional charge for topical anesthetic ointment or intraoral local anesthesia injections (dental block).

Communities served

With an office in Plano, our cosmetic surgery and plastic surgery services are also convenient to Frisco, Allen, McKinney, Richardson, Garland, Rockwall, Sherman, Irving, Las Colinas, Lewisville, Highland Village, Denton, Grapevine, Colleyville, and Southlake.

For more information and before/after photos, please see

Ronald M. Friedman, M.D.

Certified, American Board of Plastic Surgery

Director, West Plano Plastic Surgery Center

Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas

© 2018 Ronald M. Friedman, M.D., P.A.

Contact Us At 469-467-0100

Web design by Ciplex, development & marketing by Plastic Surgery Studios.