The Nonsurgical Rhinoplasty: A Retrospective Review of 5000 Treatments

Harb A, Brewster CT.

PubMed 32097303 Publisher (DOI)

What this paper says

Across 5,000 nasal filler treatments by one clinician, infection occurred in 2 patients and localized skin death in 3, with swelling and redness in roughly half as self-limiting side effects.

Overview

Nasal filler has grown as an alternative to surgery, but its safety record rests on few large series. This retrospective review reports the largest published cohort from a single clinician, using hyaluronic acid filler and a previously described technique.

Sections of note

Patient demographics, indications, treatment details and outcomes were reviewed for patients treated between March 2016 and January 2019.
The technique used was one previously described by Harb, with hyaluronic acid dermal filler.
Nonsurgical rhinoplasty was performed in 5,000 patients.
The commonest indication was dorsal hump, 44 percent.
Swelling and redness were self-limiting side effects in approximately half of patients.
Infection occurred in 2 patients.
Localized skin necrosis occurred in 3 patients. Level of evidence IV, therapeutic.

What it means for a patient

Skin death occurred in 3 of 5,000 treatments, roughly 1 in 1,700, and infection in 2, roughly 1 in 2,500.
Swelling and redness affecting about half of patients are expected rather than complications.
The most common reason for treatment was camouflaging a bump on the bridge.
Limits: retrospective, one clinician, no comparison group, no stated follow-up duration, and no data on how long the results lasted or on satisfaction.

Why this paper matters

The severe vascular complications of nasal filler are widely discussed but rarely quantified in a large series. This gives an order-of-magnitude estimate from 5,000 treatments. The results come from one experienced clinician and may not represent rates across all injectors.

Terms

Nonsurgical rhinoplasty: Reshaping the nose with injectable filler instead of surgery.
Dermal filler: An injectable gel placed under the skin to add volume.
Hyaluronic acid: A filler material that can be dissolved with an enzyme if needed.
Dorsal hump: The bump on the bridge of the nose.
Skin necrosis: Death of skin tissue from loss of blood supply.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Nonsurgical rhinoplasty with injectable dermal fillers has become an increasingly popular alternative to surgical procedures, in view of its relative low cost, convenience and rapid recovery, and low risk profile. The safety and efficacy of nonsurgical rhinoplasty remains a relatively contentious and ambiguous matter,…”

Excerpt; the full abstract is on PubMed.