A Safer Non-surgical Filler Augmentation Rhinoplasty Based on the Anatomy of the Nose.

Background: Filler augmentation rhinoplasty is a quick, non-surgical procedure that can produce outcomes comparable to open rhinoplasty surgery. However, the increased frequency of vascular complications has emerged as an important issue. The present study aimed to investigate measures to overcome the vascular complications based on the anatomy of the nose.

Methods: A colored filler was injected into cadavers for augmentation of the nasal dorsum using the retrograde injection technique and direct percutaneous injection technique. The concavity of the sellion area was measured using lateral view cephalography X-ray images. Lastly, we used ultrasonography to determine filler location in 20 Korean patients who had filler injected into the sellion area by injection at the infratip lobule.

Results: Filler was injected into the superficial layer by the retrograde injection technique in three cadavers and into the deep layer by direct percutaneous injection technique in another three cadavers. The average angle between the nasal dorsum skin and sellion was found to be 10.2 ± 2.8 degrees, while the minimum angle was 5.1 degrees. The average distance between the needle tip and nasal bone was 1.9 ± 0.3 mm, while the minimum distance was 0.4 mm.

Conclusions: When performing filler augmentation rhinoplasty on the sellion area, direct percutaneous injection from the glabella can allow more accurate injection into the supraperiosteal level, which can reduce complications such as visual loss and skin necrosis due to vascular compromise.

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 .