Nonsurgical rhinoplasty using dermal fillers

Overview

Newer injectable fillers last longer and cause fewer immune reactions than earlier products, making nonsurgical reshaping of the nose a practical alternative for some patients. The author argues that the injector needs to understand surgical nasal anatomy, especially in a nose that has already been operated on, to plan the treatment.

Sections of note

• Review article; no patient series, filler volumes, duration or complication data appear in the abstract.
• Newer injectables are described as less immunogenic and longer lasting.
• Knowledge of surgical anatomy, particularly in post-rhinoplasty patients, is emphasized for planning.
• The article outlines the evolution of nonsurgical rhinoplasty and the properties to weigh when selecting a filler.
• It describes the types of nasal deformities that injectables can treat.
• It defines the role of nonsurgical rhinoplasty within a comprehensive regimen for correcting nasal deformities.

What it means for a patient

• Small dips, asymmetries and a low bridge can be improved with filler in an office visit, without surgery.
• The result is temporary and the treatment is not suited to every deformity; the abstract does not list which are excluded.
• A previously operated nose has altered blood supply and scar, which the author flags as needing special anatomic knowledge; the abstract does not discuss vascular complications.

Why this paper matters

Filler rhinoplasty was expanding rapidly in 2013, often performed by non-surgeons. This review sets out the anatomic basis for doing it safely and frames it as a complement to surgery. Data on longevity and complication rates are not provided in the abstract.

Terms

• Nonsurgical rhinoplasty: reshaping the nose with injected filler instead of surgery.
• Dermal filler: an injectable gel, most often hyaluronic acid, used to add volume.
• Immunogenicity: the tendency of a substance to provoke an immune reaction.
• Post-rhinoplasty patient: a person whose nose has already had surgery.
• Longevity: how long a filler lasts before it is absorbed.
• Nasal deformity: any departure from normal nasal shape, from birth, injury or surgery.