Ultrasound Anatomy of the Dorsal Nasal Artery as it Relates to Liquid Rhinoplasty Procedures

Overview

Filler rhinoplasty has grown in popularity, and with it the number of cases where filler is injected into an artery and cuts off blood supply. The article analyses the anatomy of the dorsal nasal artery within the nasal soft tissue, with the stated aim of improving patient safety during these injections.

Sections of note

• Anatomical study using ultrasound; the abstract reports no patient numbers, no complication rates and no follow up.
• The dorsal nasal artery is stated to show a variable course through the nasal soft tissue.
• That variability is described as especially marked in relation to the procerus muscle.
• The authors state that understanding these courses may allow practitioners to inject with increased safety and effectiveness.
• The article links the rising frequency of the procedure to a rising incidence of arterial injection and resulting loss of blood supply.

What it means for a patient

• The danger in nasal filler comes from injecting into an artery, which can block blood flow to skin or the eye.
• The relevant artery does not follow the same path in every person, which is why depth and location matter during injection.
• No measurements, patient numbers or safety outcomes are reported in the abstract.
• The claim of increased safety from anatomical knowledge is stated as a possibility.

Why this paper matters

Filler rhinoplasty complications are anatomical in origin, and the vessels involved have been mapped mostly in cadavers rather than in living tissue. This article uses ultrasound instead. Whether knowing the variation reduces complication rates has not been demonstrated.

Terms

• Dorsal nasal artery: an artery running along the bridge of the nose, a branch of the eye's blood supply.
• Liquid or nonsurgical rhinoplasty: reshaping the nose with injectable filler instead of surgery.
• Intra-arterial injection: filler entering an artery rather than the surrounding tissue.
• Ischemia: loss of blood supply to tissue.
• Procerus muscle: the small muscle running between the eyebrows over the root of the nose.
• Topographic anatomy: the description of where structures lie relative to one another.