Medical nose reshaping: current evidence behind techniques

Alberto Diaspro , Alessio Redaelli , Yves Saban , Constantin Sulamanidze , Michele Pascali , Dario Bertossi

Plastic and Aesthetic Research ›› 2023, Vol. 10 ›› Issue (1) : 28

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Plastic and Aesthetic Research ›› 2023, Vol. 10 ›› Issue (1) :28 DOI: 10.20517/2347-9264.2022.131
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Medical nose reshaping: current evidence behind techniques

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Abstract

The nose, centrally located on the face, plays a crucial role in facial aesthetics. Any imbalance in its length, width, tip position, or a gross deformity, such as dorsal hump and deviation, can significantly affect the overall facial harmony, which is thus a major concern for patients. When it comes to minor deformities, they have been treated with hyaluronic acid, toxin injection, and thread insertion since 2005. This study has originally been carried out to review the published medical literature on the non-surgical techniques for Medical Nose Reshaping (MNR): a PubMed search was carried out in December 2020 using the search terms: “Nose [and] filler”, “Nose [and] botulinum toxin” and “Nose [and] thread”. A large number of studies were identified and reviewed, and it was found that rhinoplasty remains the gold standard to correct nose defects; nevertheless, MNR is gaining popularity due to its minimal invasiveness, short downtime, and the market availability of different injectables, toxins, and threads. This study aims to provide an evidence-based approach to guide the use of non-surgical techniques for MNR by reviewing published medical literature and drawing on the authors’ experience.

Keywords

Nose / medical / non-surgical / filler / threads / toxin

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Alberto Diaspro, Alessio Redaelli, Yves Saban, Constantin Sulamanidze, Michele Pascali, Dario Bertossi. Medical nose reshaping: current evidence behind techniques. Plastic and Aesthetic Research, 2023, 10(1): 28 DOI:10.20517/2347-9264.2022.131

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References

[1]

Hoffman K.Nose correction by palavit injection.HNO1953;4:20

[2]

Webster RC,Gaunt JM,Smith RC.Rhinoplastic revisions with injectable silicone.Arch Otolaryngol Head Neck Surg1986;112:269-76

[3]

Stupak HD,Wheatley P,Johnson CM Jr.Calcium hydroxylapatite gel (Radiesse) injection for the correction of postrhinoplasty contour deficiencies and asymmetries.Arch Facial Plast Surg2007;9:130-6

[4]

Gryskiewicz JM.Dorsal augmentation with AlloDerm.Semin Plast Surg2008;22:90-103 PMCID:PMC2884863

[5]

Redaelli A.Medical rhinoplasty with hyaluronic acid and botulinum toxin A: a very simple and quite effective technique.J Cosmet Dermatol2008;7:210-20

[6]

Hilinski JM.Soft tissue augmentation with ArteFill.Facial Plast Surg2009;25:114-9

[7]

Cassuto D.The use of Dermicol-P35 dermal filler for nonsurgical rhinoplasty.Aesthet Surg J2009;29:S22-4

[8]

Cárdenas JC.Refinement of rhinoplasty with lipoinjection.Aesthetic Plast Surg2007;31:501-5

[9]

Monreal J.Fat grafting to the nose: personal experience with 36 patients.Aesthetic Plast Surg2011;35:916-22

[10]

Klinger F,Vinci V.Minimal Invasive rhinoplasty: fat injection for nasal dorsum contouring.Ann Plast Surg2018;80:90

[11]

Giacomini PG,Mocella S,Di Girolamo S.Approach to the correction of drooping tip: common problems and solutions.Acta Otorhinolaryngol Ital2017;37:295-302 PMCID:PMC5584101

[12]

Boccieri A,Pascali M.The use of spreader grafts in primary rhinoplasty.Ann Plast Surg2005;55:127-31

[13]

Boccieri A.Septal crossbar graft for the correction of the crooked nose.Plast Reconstr Surg2003;111:629-38

[14]

Segreto F,Cerbone V.Nonsurgical rhinoplasty: a graft-based technique.Plast Reconstr Surg Glob Open2019;7:e2241 PMCID:PMC6635207

[15]

DeLorenzi C.Complications of injectable fillers, part I.Aesthet Surg J2013;33:561-75

[16]

Li KT,Chen CH.Delayed-onset cerebral infarction after cosmetic facial injection using hyaluronic acid.J Formos Med Assoc2016;115:587-8

[17]

Yoon SS,Chung KC.Acute fatal stroke immediately following autologous fat injection into the face.Neurology2003;61:1151-2

[18]

Kim EG,Kang SJ.Severe visual loss and cerebral infarction after injection of hyaluronic acid gel.J Craniofac Surg2014;25:684-6

[19]

Lee S,Seo J.Ischemic stroke caused by a hyaluronic acid gel embolism treated with tissue plasminogen activator.J Neurocritical Care2017;10:132-135.

[20]

Manafi A,Manafi A,Moghadam SA.Nasal alar necrosis following hyaluronic acid injection into nasolabial folds: a case report.World J Plast Surg2015;4:74-8 PMCID:PMC4298868

[21]

Tiryaki KT.Shuttle lifting of the nose: a minimally invasive approach for nose reshaping.Aesthet Surg J2010;30:176-83

[22]

Guyuron B.Dynamics in rhinoplasty.Plast Reconstr Surg2000;105:2257-9

[23]

Gruber RP.Suture algorithm for the broad or bulbous nasal tip.Plast Reconstr Surg2002;110:1752-68

[24]

Helmy Y.Non-surgical rhinoplasty using filler, Botox, and thread remodeling: Retro analysis of 332 cases.J Cosmet Laser Ther2018;20:293-300

[25]

Kang SH,Kim HS.Nonsurgical rhinoplasty with polydioxanone threads and fillers.Dermatol Surg2020;46:664-70

[26]

Lee HY.Rhinoplasty with barbed threads.Plast Reconstr Surg Glob Open2018;6:e1967 PMCID:PMC6414097

[27]

Cigna E,Stefanizzi G,Tarallo M.The use of botulinum toxin in the treatment of plunging nose: cosmetic results and a functional serendipity.Clin Ter2013;164:e107-13

[28]

Humphrey CD,Dayan SH.Soft tissue fillers in the nose.Aesthet Surg J2009;29:477-84

[29]

Jasin ME.Nonsurgical rhinoplasty using dermal fillers.Facial Plast Surg Clin North Am2013;21:241-52

[30]

Kurkjian TJ,Rohrich RJ.Soft-tissue fillers in rhinoplasty.Plast Reconstr Surg2014;133:121e-6e

[31]

Liew S,de Maio M.Efficacy and safety of a hyaluronic acid filler to correct aesthetically detracting or deficient features of the asian nose: a prospective, open-label, long-term study.Aesthet Surg J2016;36:760-72 PMCID:PMC4911905

[32]

Johnson ON 3rd.Nonsurgical rhinoplasty.Facial Plast Surg2016;32:500-6

[33]

Thomas WW,Friedman O.Injectables in the nose: facts and controversies.Facial Plast Surg Clin North Am2016;24:379-89

[34]

Moon HJ.Use of fillers in rhinoplasty.Clin Plast Surg2016;43:307-17

[35]

Sahan A.Non-surgical minimally invasive rhinoplasty: tips and tricks from the perspective of a dermatologist.Acta Dermatovenerol Alp Pannonica Adriat2017;26:101-3

[36]

Wang LL.Update on injectables in the nose.Curr Opin Otolaryngol Head Neck Surg2017;25:307-13

[37]

Moon HJ.Injection rhinoplasty using filler.Facial Plast Surg Clin North Am2018;26:323-30

[38]

Singh P,Nikkhah D.Filler rhinoplasty: evidence, outcomes, and complications.Aesthet Surg J2018;38:NP165-7

[39]

Jung GS.Clinical aesthetics of the nose for filler injection.Facial Plast Surg2019;35:561-2

[40]

Grunebaum LD,Dayan S,Baumann L.The risk of alar necrosis associated with dermal filler injection.Dermatol Surg2009;35 Suppl 2:1635-40

[41]

Tracy L,Nelson JS,Wong B.Calcium hydroxylapatite associated soft tissue necrosis: a case report and treatment guideline.J Plast Reconstr Aesthet Surg2014;67:564-8

[42]

Marumo Y,Hashimoto M.Visual impairment by multiple vascular embolization with hydroxyapatite particles.Orbit2018;37:165-70

[43]

Sorensen EP.Update in soft-tissue filler-associated blindness.Dermatol Surg2020;46:671-7

[44]

Bertossi D,Verner I,Nocini R.Complications and management after a nonsurgical rhinoplasty: a literature review.Dermatol Ther2019;32:e12978

[45]

Chatrath V,Goodman GJ.Soft-tissue filler-associated blindness: a systematic review of case reports and case series.Plast Reconstr Surg Glob Open2019;7:e2173 PMCID:PMC6554164

[46]

Saban Y,Hammou JC.An anatomical study of the nasal superficial musculoaponeurotic system: surgical applications in rhinoplasty.Arch Facial Plast Surg2008;10:109-15

[47]

Saban Y,Bouaziz D.Nasal arterial vasculature: medical and surgical applications.Arch Facial Plast Surg2012;14:429-36

[48]

Pilsl U.The external nose: the nasal arteries and their course in relation to the nasolabial fold and groove.Plast Reconstr Surg2016;138:830e-5e

[49]

Tansatit T,Rungsawang C.Safe planes for injection rhinoplasty: a histological analysis of midline longitudinal sections of the asian nose.Aesthetic Plast Surg2016;40:236-44

[50]

Tansatit T,Phetudom T.Facing the worst risk: confronting the dorsal nasal artery, implication for non-surgical procedures of nasal augmentation.Aesthetic Plast Surg2017;41:191-8

[51]

Choi DY,Youn KH.Topography of the dorsal nasal artery and its clinical implications for augmentation of the dorsum of the nose.J Cosmet Dermatol2018;17:637-42

[52]

Palomar-Gallego MA,Gómez-Sánchez SM,Linares García-Valdecasas R.Influence of the topographic vascular distribution of the face on dermal filler accidents.Dermatology2019;235:156-63

[53]

Dayan SH.Treatment of the lower third of the nose and dynamic nasal tip ptosis with Botox.Plast Reconstr Surg2005;115:1784-5

[54]

Ghavami A,Guyuron B.Regarding the treatment of dynamic nasal tip ptosis with botulinum toxin A.Plast Reconstr Surg2006;118:263-4

[55]

Beer KR.Nasal reconstruction using 20 mg/mL cross-linked hyaluronic acid.J Drugs Dermatol2006;5:465-466

[56]

Lacerda DA, Zancanaro P. Filler rhinoplasty.Dermatol Surg2007;33 Suppl 2:S207-S212

[57]

Rokhsar C.Nonsurgical rhinoplasty: an evaluation of injectable calcium hydroxylapatite filler for nasal contouring.Dermatol Surg2008;34:944-6

[58]

Braccini F.La rhinoplastie médicale: de l'usage de la toxine botulique et des produits de comblement pour un remodelage atraumatique du nez [Medical rhinoplasty: rationale for atraumatic nasal modelling using botulinum toxin and fillers].Rev Laryngol Otol Rhinol2008;129-:233-238

[59]

Redaelli A.Minimally invasive procedures for nasal aesthetics.J Cutan Aesthet Surg2012;5:115-20 PMCID:PMC3461788

[60]

Turkmani MG.Excessive columellar show: causes, presentations and a new therapeutic approach with onabotulinum toxin A.Dermatol Surg2013;39:464-7

[61]

Modrzyński M.[The minimally invasive rhinoplasty with hyaluronic acid and botulinum toxin in a 49-year old woman].Otolaryngol Pol2010;64:324-7

[62]

Piggott JR.Hyaluronic acid used for the correction of nasal deviation in an 18-year-old Middle Eastern man.Can J Plast Surg2011;19:156-8

[63]

Tanaka Y,Yuzuriha S.Westernization of the asian nose by augmentation of the retropositioned anterior nasal spine with an injectable filler.Eplasty2011;11:e7. PMCID:PMC3041501

[64]

Kim P.Structured nonsurgical Asian rhinoplasty.Aesthetic Plast Surg2012;36:698-703

[65]

Wang YF,Liu KL.A woman's secret. Filler rhinoplasty with Radiesse (Merz Aesthetics, San Mateo, CA) and gold thread implantation.Ann Emerg Med2013;62:224, 234

[66]

Tanaka Y.Oriental nose occidentalization and perinasal shaping by augmentation of the underdeveloped anterior nasal spine.Plast Reconstr Surg Glob Open2014;2:e197 PMCID:PMC4236358

[67]

Hedén P.Nasal reshaping with hyaluronic acid: an alternative or complement to surgery.Plast Reconstr Surg Glob Open2016;4:e1120 PMCID:PMC5142491

[68]

Borchard NA,Yan CH,Thamboo A.Use of intranasal submucosal fillers as a transient implant to alter upper airway aerodynamics: implications for the assessment of empty nose syndrome.Int Forum Allergy Rhinol2019;9:681-7

[69]

Cervelli V,Bottini JD.Alar batten cartilage graft: treatment of internal and external nasal valve collapse.Aesthetic Plast Surg2009;33:625-34

[70]

Jung GS,Lee JW.A Safer Non-surgical filler augmentation rhinoplasty based on the anatomy of the nose.Aesthetic Plast Surg2019;43:447-52

[71]

Mehta U.Advanced techniques in nonsurgical rhinoplasty.Facial Plast Surg Clin North Am2019;27:355-65

[72]

Singh S.Practical tips and techniques for injection rhinoplasty.J Cutan Aesthet Surg2019;12:60-2 PMCID:PMC6484576

[73]

Bertossi D,Dell'Acqua I,Malchiodi L.Injectable profiloplasty: forehead, nose, lips, and chin filler treatment.J Cosmet Dermatol2019;18:976-84

[74]

Jung GS.Filler rhinoplasty based on anatomy: the dual plane technique.JPRAS Open2019;20:94-100 PMCID:PMC7061673

[75]

Kim HJ,Lee JH,Suh IS.Clinical features of skin infection after rhinoplasty with only absorbable thread (polydioxanone) in oriental traditional medicine: a case series study.Aesthetic Plast Surg2020;44:139-47

[76]

Rauso R,Zerbinati N.Safety and early satisfaction assessment of patients seeking nonsurgical rhinoplasty with filler.J Cutan Aesthet Surg2017;10:207-14 PMCID:PMC5820838

[77]

Bravo BSF,Mariano Da Rocha C.Evaluation and proportion in nasal filling with hyaluronic acid.J Clin Aesthet Dermatol2018;11:36-40. PMCID:PMC5891085

[78]

Santorelli A.Non-surgical rhinoplasty with hyaluronic acid fillers: predictable results using software for the evaluation of nasal angles.Aesthetic Plast Surg2020;44:919-26

[79]

Rho NK,Youn CS,Kim HS.Early changes in facial profile following structured filler rhinoplasty: an anthropometric analysis using a 3-dimensional imaging system.Dermatol Surg2017;43:255-63

[80]

Schuster B.Injection rhinoplasty with hyaluronic acid and calcium hydroxyapatite: a retrospective survey investigating outcome and complication rates.Facial Plast Surg2015;31:301-7

[81]

Rosa L, Cerulli G, De Pasquale A. Psychological analysis of non-surgical rhinoplasty.Aesthetic Plast Surg2020;44:131-8

[82]

Siclovan HR.Injectable calcium hydroxylapatite for correction of nasal bridge deformities.Aesthetic Plast Surg2009;33:544-8

[83]

Erol OO.Microfat grafting in nasal surgery.Aesthet Surg J2014;34:671-86

[84]

Rivkin A.A prospective study of non-surgical primary rhinoplasty using a polymethylmethacrylate injectable implant.Dermatol Surg2014;40:305-13

[85]

Chen L,Yu P.Comparison of artecoll, restylane and silicone for augmentation rhinoplasty in 378 chinese patients.Clin Invest Med2014;37:E203-10

[86]

Trivisonno A,Magalon G.Fluid cartilage as new autologous biomaterial in the treatment of minor nose defects: clinical and microscopic difference amongst diced, crushed, and fluid cartilage.Materials2019;12:1062 PMCID:PMC6479609

[87]

Boccieri A,Pascali M.Crushed cartilage: a rescue procedure in rhinoplasty.J Craniofac Surg2018;29:614-7

[88]

Saban Y,Massa M.Nasal lift-nasal valve lift and nasal tip lift-preliminary results of a new technique using noninvasive self-retaining unidirectional nasal suspension with threads.Facial Plast Surg2014;30:661-9

[89]

Lee MJ,Kim NJ,Khwarg SI.Eyelid mass secondary to injection of calcium hydroxylapatite facial filler.Ophthalmic Plast Reconstr Surg2008;24:421-3

[90]

Inoue K,Matsumoto D,Yoshimura K.Arterial embolization and skin necrosis of the nasal ala following injection of dermal fillers.Plast Reconstr Surg2008;121:127e-8e

[91]

Colombo G,Stifanese R.A vast intranasal filler-induced granulomatous reaction: a case report.Aesthetic Plast Surg2010;34:660-3

[92]

Sung MS,Woo KI.Ocular ischemia and ischemic oculomotor nerve palsy after vascular embolization of injectable calcium hydroxylapatite filler.Ophthalmic Plast Reconstr Surg2010;26:289-91

[93]

Kim YJ,Song WK,Yoon JS.Ocular ischemia with hypotony after injection of hyaluronic acid gel.Ophthalmic Plast Reconstr Surg2011;27:e152-5

[94]

Kim SG,Lee SI.Salvage of nasal skin in a case of venous compromise after hyaluronic acid filler injection using prostaglandin E.Dermatol Surg2011;37:1817-9

[95]

Kang MS,Shin HS,Kim YB.Skin necrosis of the nasal ala after injection of dermal fillers.Dermatol Surg2011;37:375-80

[96]

Kim YJ.Bilateral blindness after filler injection.Plast Reconstr Surg2013;131:298e-9e

[97]

Honart JF,Mazouz Dorval S,Revol M.[A case of nasal tip necrosis after hyaluronic acid injection].Ann Chir Plast Esthet2013;58:676-9

[98]

Kim SN,Park JH.Panophthalmoplegia and vision loss after cosmetic nasal dorsum injection.J Clin Neurosci2014;21:678-80

[99]

Lazzeri D,Zhang YX,Lazzeri S.Panophthalmoplegia and vision loss after cosmetic nasal dorsum injection.J Clin Neurosci2014;21:890

[100]

Lazzeri D,Figus M,Pantaloni M.Blindness following cosmetic injections of the face.Plast Reconstr Surg2012;129:995-1012

[101]

Chang C.Unusual long-term complication of polyalkylimide hydrogel manifesting as nasal septal abscess.J Craniofac Surg2015;26:e197-9

[102]

Chou CC,Tsai YY,Lin HJ.Choroid vascular occlusion and ischemic optic neuropathy after facial calcium hydroxyapatite injection- a case report.BMC Surg2015;15:21 PMCID:PMC4359764

[103]

Kim SK,Hwang K.Skin necrosis of the nose after injection of ribose cross-linked porcine atelocollagen.J Craniofac Surg2015;26:2211-2

[104]

Lin YC,Liao WC.Central retinal artery occlusion and brain infarctions after nasal filler injection.QJM2015;108:731-2

[105]

Alharethy S.Alterations in nasal sensibility following calcium hydroxyapatite dorsal augmentation.J Craniofac Surg2018;29:e104-6

[106]

Vu PQ,Tao JP.Light perception vision recovery after treatment for calcium hydroxylapatite cosmetic filler-induced blindness.Ophthalmic Plast Reconstr Surg2018;34:e189-92

[107]

Vidič M.An adverse reaction after hyaluronic acid filler application: a case report.Acta Dermatovenerol Alp Pannonica Adriat2018;27:165-167.

[108]

Bae IH,Choi H,Shin BS.Ischemic oculomotor nerve palsy due to hyaluronic acid filler injection.J Cosmet Dermatol2018;17:1016-8

[109]

Robati RM,Almasi-Nasrabadi M.The risk of skin necrosis following hyaluronic acid filler injection in patients with a history of cosmetic rhinoplasty.Aesthet Surg J2018;38:883-8

[110]

Hu HC,Chiu YH.Dermatomyositis induced by filler rhinoplasty using liquid silicone.JAMA Otolaryngol Head Neck Surg2020;146:205-6

[111]

Ansari ZA,Rong AJ,Tse DT.Ocular and cerebral infarction from periocular filler injection.Orbit2019;38:322-4

[112]

Huang P,Ren H.Color doppler flow imaging of retrobulbar ocular blood flow changes in retinal artery occlusions caused by cosmetic facial filler injections.Ophthalmic Plast Reconstr Surg2019;35:227-31

[113]

Cohen E,Leibovitch I.A case report of ophthalmic artery emboli secondary to Calcium Hydroxylapatite filler injection for nose augmentation- long-term outcome.BMC Ophthalmol2016;16:98 PMCID:PMC4938948

[114]

Chae SY,Jang YH,Kim DW.A case of the migration of hyaluronic acid filler from nose to forehead occurring as two sequential soft lumps.Ann Dermatol2016;28:645-7 PMCID:PMC5064200

[115]

Chen W,Jian XL.Retinal branch artery embolization following hyaluronic acid injection: a case report.Aesthet Surg J2016;36:NP219-24

[116]

Megías-Vericat JE,Ribes-Artero H.Prostaglandin Injection after arterial compromise related to hyaluronic acid filler.Dermatol Surg2017;43:975-7

[117]

Wu S,Wu H.Anatomic study of ophthalmic artery embolism following cosmetic injection.J Craniofac Surg2017;28:1578-81

[118]

Townshend A.Blindness after facial injection.J Clin Aesthet Derm2016;9:e5-7 PMCID:PMC5300728

[119]

Bray D,Roberts DN.Injection rhinoplasty: non-surgical nasal augmentation and correction of post-rhinoplasty contour asymmetries with hyaluronic acid: how we do it.Clin Otolaryngol2010;35:227-30

[120]

Sundaram H,Beer K.Comparison of the rheological properties of viscosity and elasticity in two categories of soft tissue fillers: calcium hydroxylapatite and hyaluronic acid.Dermatol Surg2010;36 Suppl 3:1859-65

[121]

Michaels M.Rheological properties of several hyaluronic acid-based gels: a comparative study. J Drug Dermatol 2018;17:948-54.

[122]

Nguyen PS,Casanova D,Magalon G.[Autologous fat grafting and rhinoplasty].Ann Chir Plast Esthet2014;59:548-54

[123]

Kao WP,Lin TY.Microautologous fat transplantation for primary augmentation rhinoplasty: long-term monitoring of 198 asian patients.Aesthet Surg J2016;36:648-56 PMCID:PMC5127412

[124]

Lin S,Huang JJ.Minimal invasive rhinoplasty: fat injection for nasal dorsum contouring.Ann Plast Surg2017;78:S117-23

[125]

Toriumi DM.Dorsal augmentation using autologous costal cartilage or microfat-infused soft tissue augmentation.Facial Plast Surg2017;33:162-78

[126]

Bertossi D,Albanese M,Nocini P.Nonsurgical rhinoplasty with the novel hyaluronic acid filler vyc-25l: results using a nasal grid approach.Aesthet Surg J2021;41:NP512-20

[127]

Sulamanidze C,Diaspro A.Thread lifting of the nose: fully comprehensive approach to the technique.Plast Reconstr Surg Glob Open2023;11:e4907 PMCID:PMC10069852

[128]

Kim KS.Benign nasal mass as a delayed complication of barbed thread rhinoplasty.J Craniofac Surg2022;33:e503-5

[129]

Jin HR.Presentation patterns and surgical management of the complications of thread rhinoplasty.Clin Exp Otorhinolaryngol2022;15:247-53 PMCID:PMC9441499

[130]

Eaves F 3rd.Why evidence-based medicine matters to aesthetic surgery.Aesthet Surg J2012;32:117-9

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