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Journal archive · Non-surgical and filler rhinoplasty · Outcomes, satisfaction and psychology · Complications and management · 2024

APS Aesthetic Plastic Surgery · 2024

The Use of Hyaluronic Acid in Non-surgical Rhinoplasty: A Systematic Review of Complications, Clinical, and Patient-Reported Outcomes

Mortada H, Korb A, Mawdsley E, Suresh J, Xu J, Koorapaty P, Khajuria A.

What this paper says

A PROSPERO-registered systematic review of 23 studies and 3,928 patients found hyaluronic acid filler rhinoplasty gave high satisfaction with eight major complications, most often used for humps and injected at the tip and columella.

Overview

Filler rhinoplasty is common but its outcomes had not been systematically reviewed. Following PRISMA, the authors searched MEDLINE, EMBASE and Cochrane with three independent reviewers screening, and appraised quality with MINORS and case-series tools.

Sections of note

  • 874 records found; 23 full-text articles and 3,928 patients included.
  • Juvederm Ultra was the most commonly used filler.
  • The tip was the most injected site (13 studies), then the columella (12).
  • Dorsal hump was the commonest indication.
  • All studies reported high satisfaction; eight patients developed major complications. Level of Evidence III.

What it means for a patient

  • Across nearly 4,000 patients, serious complications were rare (8) and satisfaction high.
  • The tip and columella are common injection sites, but the bridge is also frequently treated for humps.
  • The authors call for randomised trials; the evidence is observational.

Why this paper matters

It is the first registered systematic review of hyaluronic acid rhinoplasty and the subject of a subsequent published exchange on filler rheology. Limits: observational studies, varied products and follow-up, likely under-reporting of complications.

Terms

  • Non-surgical rhinoplasty: reshaping with injectable filler.
  • Hyaluronic acid (HA): the most common filler material.
  • MINORS: a quality score for non-randomised surgical studies.
  • PROSPERO: an international register of systematic reviews.
  • Major complication: here, events such as vascular occlusion or tissue loss.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

Abstract

Introduction: In cosmetic practices, non-surgical rhinoplasty using filler injections has become increasingly common. Nevertheless, the outcome and overall complications have not been studied as a systematic review in the literature. This study provides a high-quality systematic review of studies reporting clinical and patient-reported outcomes following non-surgical rhinoplasty with hyaluronic acid (HA) to further guide practitioners.

Methods: This systematic review was conducted in accordance with PRISMA guidelines and was registered in PROSPERO. The search was conducted using MEDLINE, EMBASE, and Cochrane. The literature retrieval was conducted by three independent reviewers, and the remaining articles were screened by two independent reviewers. The quality of included articles was assessed using the MINORS and methodological quality and synthesis of case series and case reports tools.

Results: A total of 874 publications were found based on the search criteria. A total of 3928 patients were reviewed for this systematic review from 23 full-text articles. For non-surgical rhinoplasty, Juvéderm ultra was the most commonly used HA filler. The nasal tip was most commonly injected (13 studies), followed by the columella (12 studies). Nasal hump deformities are the most common reason for non-surgical rhinoplasty. All studies showed high patient satisfaction. Among all patients reviewed, eight developed major complications.

Conclusion: Non-surgical rhinoplasty performed with HA has minimal side effects and a short recovery period. Furthermore, non-surgical rhinoplasty with HA results in high satisfaction. To strengthen the presently available evidence, further well-designed RCTs are needed.

Level Of Evidence Iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266.

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

Citation

PubMed
Journal
Aesthetic Plastic Surgery
Year
2024
Authors
7
Type
Journal Article, Systematic Review, Research Support, Non-U.S. Gov't
Access
Open access
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