Standardized Non-surgical Rhinoplasty with Hyaluronic Acid

Additionally, the nasofrontal angle decreased by an average of 0.37 degrees, and the columellar-labial angle increased by an average of  5.97 degrees (Figure 11). After the end of the procedure, a sterile dressing is placed over the entry point site. A micropore is placed along the dorsum and around the tip to protect and maintain the remodeling.
These findings indicate that the combination of threads, HA filler, and botulinum toxin results in higher patient satisfaction 自体血清 and improved aesthetic outcomes in both the short and long term. The nose, as a central feature of the face, plays a pivotal role in defining facial aesthetics. Key anatomical elements such as the nasal dorsum, tip, alar base, and internal nasal valve collectively contribute to its overall appearance [1]. Consequently, rhinoplasty is among the most performed procedures worldwide and remains a significant topic for scientific discussions, hands‐on courses, and innovative surgical laboratories [2]. Prior to treatment, the patient should be fully assessed and informed of the risks, complications and expectations, and an informed consent obtained to perform the procedure. Non-surgical rhinoplasty is a modern alternative to traditional surgical rhinoplasty.

Preventative measures, precise techniques, and thorough anatomical knowledge can mitigate risks, ensuring better patient outcomes. Patient is well counselled prior to the procedure about their individual expectations and realistic outcomes. Prior to the procedure, prilociane or EMLA 5% cream (25 mg lidocaine + 25 mg prilocaine) is applied locally for topic anaesthesia.
This contrasts with the approach used in the other study, which employed a combination of cannulas and needles [19]. The findings of this retrospective study reinforce the clinical applicability of non-surgical rhinoplasty with HA as a minimally invasive, effective, and safe alternative for nasal reshaping. Overall, patient-reported outcomes were favorable across all injector experience levels, as reflected by the GAIS scores. However, a statistically significant correlation was observed between greater clinical experience and higher satisfaction scores, highlighting the importance of technical expertise in the patient’s final aesthetic perception.

Among these, the triple combination of HA filler, BTX, and lifting threads results in the highest and most sustained patient satisfaction, lasting no less than 1 year. For example, a 2020 research study reviewed the outcomes, safety, and complication rates of non-surgical rhinoplasty using HA dermal fillers in over 5,000 patients. The study reported few complications, with an infection rate of 0.04% and a skin necrosis rate of 0.06%.
Identified literature was systematically analyzed to synthesize evidence on filler mechanisms, clinical applications, and safety management strategies. In recent years, an aging population, heightened awareness of aesthetic appearance, and advances in medical aesthetic technology have fueled a boom in the global medical aesthetic surgery industry [1]. The global medical aesthetics market is projected to approach $125  billion by 2028, underscoring the widespread and increasing use of aesthetic procedures and the accompanying need for stricter safety protocols and clinical guidelines. A survey by the American Society for Dermatologic Surgery indicates that approximately 70% of consumers consider cosmetic surgery to enhance self-confidence and to appear younger and more attractive. Worldwide, minimally invasive and facial injectable filler procedures are gaining popularity [2]. Aesthetic medicine, a medical specialty focused on enhancing physical appearance through minimally invasive or nonsurgical methods, is all about symmetry, proportion, and patient satisfaction [4].
Clinical symptoms consistently reported across all patients included significant pain, pallor, swelling, and characteristic “spotted” or “map‐like” ischemic skin discolorations (41/41, 100%). Numbness was experienced by over half of the cohort (22/41, 53.7%), and bleeding at the injection site was comparatively uncommon, affecting only 9.8% (4/41). While rare, serious complications from nose injections can include infection, granuloma formation, and vascular occlusion. The proximity of the nose to critical blood vessels makes it a higher-risk area for these complications than other facial regions. Our study aimed to evaluate the aesthetic outcome, longevity of results, safety, and patient satisfaction with the novel Rino-4-Puntos (R4P) NSR technique.

Deep learning, a subset of ML, uses multi‐layered neural networks to process complex data—like facial features or skin textures—with remarkable accuracy [13]. Together, these technologies form the backbone of AI's capability to mimic and augment human expertise, particularly in fields requiring precision and adaptability [14]. Rivkin presented advances in non-surgical nose job treatments to a global forum of expert injectors.
When these features are integrated with telehealth, clinicians are able to catch conditions earlier and offer individualized advice on sun avoidance, nutrition, or procedures that are minimally invasive. This forward‐looking strategy not only enhances long‐term outcomes but positions aesthetic medicine in concert with broader trends in preventive medicine, oriented toward wellness instead of overreactive intervention [72]. AI is also releasing the promise of genomics and biomarkers to introduce precision into aesthetic treatments [58].
Clinicians must explain how AI systems aid in treatment planning, as well as their limitations and probabilistic nature [50]. Combining XAI systems and ethical regulation can close the gap between high‐tech capability and patient understanding, facilitating informed consent and shared decision‐making [63]. These technologies do more than improve clinical judgment; they extend the limits of what may be perceived, creating a better and wiser consultation process [38]. The Non-Surgical Rhinoplasty procedure starts with photography so that we have a clear record of how your nose looked before the procedure. We then apply topical numbing cream to the nose and let it sit for 20 to 30 minutes.

The nose FACE‐Q module is a part of the FACE‐Q scales, it consists of 10 validated questions concerning patient's satisfaction with nose and four questions about adverse effects regarding the nose. For each question, a 4‐point scaling is used, with 1 being the minimal score for each question, and 4 being the maximal assessment. Individual scores were calculated as total out of 40 for patient satisfaction questionnaire or 16 for adverse effects. Nose adverse effects evaluation using FACE‐Q was performed by study subjects 48 h and 1 week after treatment for the purpose of safety assessment. Patients receiving threads treatment assessed the adverse effects 48 h and 1 week after the thread treatment but not after the additional treatment (BTX and, if needed, HA filler) 2 weeks later.
After injection, the bovine collagen component degrades within 1 to 3 months, while PMMA remains encapsulated by fibrous tissue, providing a long-lasting filler effect. However, the product requires preliminary allergy testing because of its composition. In a 2-year prospective study led by Hevia, patient satisfaction levels were high, with 82% and 100% of patients expressing being at least “a little satisfied” at 52 and 104 weeks, respectively. Moreover, more than 90% of patients showed significant improvement in the treatment of the mandibular sulcus, with all reported adverse events being minor [81]. Solomon et al, in a retrospective analysis of a third-generation PMMA filler (Bellafill; Suneva Medical, Inc), recorded only 6 adverse events out of 417 procedures, indicating high patient satisfaction [82].

Three retrospective articles were eligible for inclusion in the review. Thirteen patients were operated on for rhinoplasty who previously received nSNR with HA. Six received hyaluronidase injections before surgery and 7 underwent directly to surgery. Among the 7 who went straight to surgery, in 5 of them, 6 months was the specified time lapse between last HA injection and surgery. Among the ones receiving hyaluronidase injection before surgery, the time lapse reported was 6 months for 1 patient, 3 months for 2 patients, 2 months for 1 patient and 7 days for 1 patient. Hyaluronic acid filler rhinoplasty results typically last twelve to eighteen months, after which the filler is gradually metabolised by the body and the nose returns to its original shape.
HA fillers have been extensively tested for safety, making allergic reactions uncommon. Clinically, vascular embolism from HA fillers is characterized by significant pain and distinctive ischemic discoloration at the injection site, often delayed by the presence of lidocaine [9]. If not rapidly diagnosed and treated, ischemic injuries can escalate to severe necrosis, ulceration, and irreversible tissue damage, resembling damage seen in compromised skin flaps [10]. At Cosmetic Laser Dermatology, we believe in providing comprehensive education about all cosmetic procedures, including their limitations and risks. Nose injection filler can be an appropriate option for select patients,  but only when performed by experienced practitioners who prioritize safety and realistic outcomes.