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A literature review identified fifteen clinical considerations that may improve the safety of nonsurgical rhinoplasty with hyaluronic acid, although the available evidence remains limited and is primarily based on expert opinions.
Nonsurgical rhinoplasty is a widely performed procedure, but many clinicians still consider it high-risk because of the potential for serious and potentially irreversible complications, including vascular compromise. This narrative review aimed to identify and define clinical measures that may improve procedural safety for both clinicians and patients.
The authors searched the PubMed/MEDLINE and Cochrane databases for studies on nonsurgical rhinoplasty using hyaluronic acid fillers. Of the 71 articles initially identified, 16 met the inclusion criteria. The analysis focused on the instruments used, preventive maneuvers, anatomical injection sites, and the characteristics of the hyaluronic acid fillers employed.
Key considerations include appropriate needle or cannula selection, the use of high-G' hyaluronic acid fillers, deep midline injections with careful aspiration and stabilization, the use of a new needle for each injection, slow administration of very small volumes, the option of starting in lower-risk zones, digital compression to limit filler spread, and increased caution in previously operated noses. In total, the review identified fifteen considerations. However, the authors note that the available evidence remains limited: most recommendations are primarily based on expert opinion and detailed anatomical knowledge.
During the consultation, patients can ask the practitioner what type of filler will be used, whether it will be injected with a needle or a cannula, and what measures will be taken to reduce the risk of vascular complications. If the nose has been operated on before, it is worth mentioning: the review notes that greater caution is recommended in those cases.
This content summarizes scientific publications and professional-society guidelines; it does not replace your surgeon's or anesthesiologist's evaluation. Every item links its original source.