PMMA-collagen Gel in Nonsurgical Rhinoplasty Defects: A Methodological Overview and 15-year Experience

Rivkin A.

PubMed 35999875 Publisher (DOI)Free full text (PMC)

What this paper says

An overview drawing on more than 1,000 patients treated over 15 years with a permanent filler for non surgical rhinoplasty, including patient images with 10 years of follow up.

Overview

Non surgical rhinoplasty is an alternative for patients wanting correction of mild to moderate nasal appearance concerns without surgery, whether from concern about risk, recovery time or cost. The authors state it is not a substitute for surgery but can be more accessible and, for certain defects, more precise. Polymethylmethacrylate collagen gel is presented as a permanent option for suitable candidates.

Sections of note

Methodological overview drawing on the author's 15 years and more than 1,000 patients.
The abstract reports no complication rates, no satisfaction scores and no systematic outcome data.
Optimal use is stated to depend on expert level injector experience plus careful patient selection and education.
The article covers relevant anatomy, a methodological overview including patient selection, and a video of injection technique.
The authors state this is the first published guidance on non surgical rhinoplasty using a permanent filler.
Patient images with 10 years of follow up are included to illustrate durability.
The stated conclusion is that the gel is effective where permanent correction is desired.

What it means for a patient

Unlike hyaluronic acid, this material is permanent and cannot be dissolved if the result is unwanted or a complication occurs.
That permanence is presented as the advantage and is also the central risk.
No complication rate is reported despite the series covering more than 1,000 patients over 15 years.
The included images are selected examples, not a systematic sample of results.

Why this paper matters

Reversibility is the main safety argument for hyaluronic acid in the nose, since the reversal agent is the only rescue for a blocked vessel. This article documents long term use of a permanent alternative. Without reported complication data its safety claim rests on the author's experience alone.

Terms

PMMA: polymethylmethacrylate, a permanent synthetic microsphere material.
Collagen gel: the carrier in which the permanent microspheres are suspended.
Permanent filler: an injectable that the body does not absorb and that cannot be dissolved.
Nonsurgical rhinoplasty: reshaping the nose with injectable filler instead of surgery.
Patient selection: choosing which patients are suitable for a given treatment.

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

Abstract

Unlabelled: Nonsurgical rhinoplasty (NSR) is an alternative to surgical rhinoplasty for patients who desire correction of mild-to-moderate aesthetic nasal defects but do not wish to undergo surgery due to concern about risks, recovery time, or cost. Although not a surrogate, NSR can be a more accessible and more precise modality for achieving aesthetic goals. Furthermore, for certain types of defects, the precision possible with filler injection versus surgery can make NSR the preferred procedure. In these instances, polymethylmethacrylate (PMMA)-collagen gel is a valuable tool for appropriate candidates due to its permanence and its favorable safety profile when injected appropriately.

Methods: Optimal use of PMMA-collagen gel for NSR is predicated on expert-level injector experience and careful patient selection and education. The author draws on over 15 years of experience treating more than 1000 NSR patients with PMMA-collagen gel to provide a discussion of relevant anatomy; methodological overview, including patient selection; and a video describing injection technique of NSR with PMMA-collagen gel.

Results: To our knowledge, this is the first published guidance on NSR with permanent filler. In addition to the clinical experience provided, patient images with 10 years of follow-up are included to illustrate the durability of the results and the continued natural appearance of the correction as the treated patients continue to age.

Conclusion: In patients with aesthetic nasal deficits treated with filler, where permanent correction is desired, the appropriate use of PMMA-collagen gel is an effective treatment option.

Abstract as indexed by PubMed; the article is open access (PubMed Central).