Ramtin Kassir1, Aniketh Venkataram2, Azyta Malek1, Deeksha Rao3. 1. Park Avenue Plastic Surgery and Dermatology, 799 Park Avenue, NewYork, NY, 10021, USA. 2. The Venkat Center for Skin ENT & plastic surgery, 3437, 1st G cross, 7th Main, Subbanna Gardens, Vijaynagar, Bangalore, 40, India. draniketh@venkatcenter.com. 3. The Venkat Center for Skin ENT & plastic surgery, 3437, 1st G cross, 7th Main, Subbanna Gardens, Vijaynagar, Bangalore, 40, India.
Abstract
INTRODUCTION: Non-surgical rhinoplasty or liquid/filler rhinoplasty is one of the fastest-growing cosmetic procedures worldwide. While several papers have been published on this topic, there has been no standardization of the technique. Most techniques advise injection in a top-down manner, similar to a traditional rhinoplasty. We present our ascending technique performed in 2130 cases. This constitutes one of the largest series published on this subject. METHODS: Patient records were retrospectively analysed from 2006 to 2019. All patients were injected with hyaluronic acid fillers. We employed an ascending approach which consisted of four sites: nasal tip, columellar base, dorsum (including supratip) and radix. The tip was first set at the appropriate projection and rotation and then the dorsum adjusted to meet it. RESULTS: Since 2006, 2130 patients underwent non-surgical rhinoplasty; 2023 patients were female (95%), and 107 were male (5%). The proportions by site injected were tip 95%, columella 58%, dorsum 83%, radix 62%. Sixty-two percent (1321) repeated the procedure after 1 year. Two percent of patients had persistent tip redness which recovered. There was no skin necrosis or ocular complications. CONCLUSIONS: In non-surgical rhinoplasty, all modifications are being done by pure addition, unlike surgical rhinoplasty. In this scenario, the risk of over-projecting the tip is higher. Hence, we believe it is important to set the tip at the desired projection and size and then raise the dorsum accordingly to match. Our high satisfaction rate over 2130 patients validates the efficacy of this ascending technique. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors - www.springer.com/00266 .
INTRODUCTION: Non-surgical rhinoplasty or liquid/filler rhinoplasty is one of the fastest-growing cosmetic procedures worldwide. While several papers have been published on this topic, there has been no standardization of the technique. Most techniques advise injection in a top-down manner, similar to a traditional rhinoplasty. We present our ascending technique performed in 2130 cases. This constitutes one of the largest series published on this subject. METHODS:Patient records were retrospectively analysed from 2006 to 2019. All patients were injected with hyaluronic acid fillers. We employed an ascending approach which consisted of four sites: nasal tip, columellar base, dorsum (including supratip) and radix. The tip was first set at the appropriate projection and rotation and then the dorsum adjusted to meet it. RESULTS: Since 2006, 2130 patients underwent non-surgical rhinoplasty; 2023 patients were female (95%), and 107 were male (5%). The proportions by site injected were tip 95%, columella 58%, dorsum 83%, radix 62%. Sixty-two percent (1321) repeated the procedure after 1 year. Two percent of patients had persistent tip redness which recovered. There was no skin necrosis or ocular complications. CONCLUSIONS: In non-surgical rhinoplasty, all modifications are being done by pure addition, unlike surgical rhinoplasty. In this scenario, the risk of over-projecting the tip is higher. Hence, we believe it is important to set the tip at the desired projection and size and then raise the dorsum accordingly to match. Our high satisfaction rate over 2130 patients validates the efficacy of this ascending technique. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors - www.springer.com/00266 .