Nonsurgical Rhinoplasty Using Injectable Fillers: A Safety Review of 2488 Procedures

Rivkin A.

What this paper says

Across 2,488 filler rhinoplasty procedures by one injector over 10 years, 7.6 percent had an adverse event and 5 cases, 0.20 percent, were serious, involving loss of blood supply and tissue death.

Overview

Injectable fillers are used worldwide to change the shape of the nose without surgery, and blindness and skin death have both been reported as consequences. This retrospective chart review set out to determine an overall adverse event rate and to test whether previous surgical rhinoplasty raises the odds of one. Records covered 2,275 patients and 2,488 procedures from a single physician injector across a 10 year period.

Sections of note

Retrospective chart review, single injector; 2,275 patients and 2,488 procedures.
Overall procedural adverse event rate was 7.6 percent.
Five cases, 0.20 percent, were considered serious, specifically ischemia and necrosis.
Patients with previous surgical rhinoplasty had a 10.8 percent adverse event rate versus 7.4 percent in those without.
The odds ratio for previous surgery was 1.51, 95 percent confidence interval 1.03 to 2.18, P equals 0.032.
Injecting the tip and the sidewall of the nose carried the highest adverse event rates in both groups.
Most adverse events were common injection site reactions.

What it means for a patient

Roughly one procedure in 13 produced some adverse event, though the great majority were minor local reactions.
Serious events involving tissue death occurred in about one procedure in 500.
A nose that has already been operated on carried significantly higher risk, which the author attributes to altered anatomy.
This is one injector's practice reviewed retrospectively, with no independent verification and no comparison technique.

Why this paper matters

Filler rhinoplasty is performed in very large numbers with limited published safety data, and the nose is where filler complications are most severe. This series supplies a rate from a sizeable cohort and identifies previous surgery and specific injection sites as risk factors. It cannot establish how those rates vary between injectors.

Terms

Adverse event: any unwanted effect following the procedure.
Ischemia: loss of blood supply to tissue.
Necrosis: death of tissue, here skin.
Odds ratio: how much more likely an event is in one group than another.
Sidewall: the side surface of the nose between the bridge and the cheek.

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

From the abstract

“Injectable fillers are used worldwide to improve the appearance of the nose by nonsurgical methods. The procedure is not without risks, as blindness and skin necrosis have been reported as a consequence of filler injections in the nose. Objective: To determine an overall adverse event (AE) rate for the nonsurgical…”

Excerpt; the full abstract is on PubMed.