Nonsurgical Rhinoplasty With the Novel Hyaluronic Acid Filler VYC-25L: Results Using a Nasal Grid Approach

Overview

Nonsurgical reshaping of the nose with injectable filler is increasingly common. VYC-25L is a hyaluronic acid product with the firmness and cohesiveness the authors say a nasal filler requires. This retrospective single centre analysis assessed its safety and effectiveness in adults treated between February and April 2019 using a previously published grid system that dictates how much filler goes where and in what order.

Sections of note

• Retrospective, single centre analysis of 61 patients; mean age 32 years, 45 female, 74 percent.
• Procedures included correcting inadequate projection, deep glabella treatment, correcting a nasal hump, and adjusting the nasolabial angle and columella.
• Follow up ran 6 to 9 months.
• At 2 weeks, independent evaluation scored every patient 9 or 10 on a 10 point visual analog scale for defect correction.
• Fifty nine of 61 patients, 97 percent, rated their own correction as adequate.
• Results were stable at the 3 month and 6 month visits.
• Complications were bruising in 15 patients, 25 percent, asymmetry in 2, 3 percent, and hematoma in 1, 2 percent, all resolving rapidly.
• There were no cases of infection, visible bumps or skin death.

What it means for a patient

• Filler can raise the bridge and change the angle between nose and lip without surgery.
• Bruising was common; the serious complications feared with nasal filler did not occur here.
• Sixty one patients at one centre is too small to detect rare events such as blocked blood vessels.
• Follow up stopped at 6 to 9 months, so longer duration is not reported.

Why this paper matters

Injectable nose reshaping has spread faster than the safety data behind it, and the nose is the facial area where filler complications are most severe. This study reports one product used under a defined protocol. Rare vascular complications and results past a year remain unmeasured.

Terms

• Hyaluronic acid filler: an injectable gel that adds volume and can be dissolved if needed.
• G prime: a measure of a filler's firmness and resistance to deformation.
• Glabella: the flat area between the eyebrows.
• Nasolabial angle: the angle formed between the base of the nose and the upper lip.
• Visual analog scale: a rating along a line, here from 0 to 10.