Advancing the Era of Liquid Rhinoplasty: A Methodological Approach to Injection Protocols

Radulesco T, Ebode D, Michel J.

PubMed 38627333 Publisher (DOI)Free full text (PMC)

What this paper says

A proposed standardised filler protocol organising injections into dorsal, paramedian, tip and endonasal sites and matching them to nasal shapes such as droopy tips, humps, saddle noses, inverted-V deformity, twisted noses, revision irregularities and internal valve dysfunction.

Overview

The French authors argue that inconsistent injection practice threatens safety and results in filler rhinoplasty. This article proposes a systematic protocol for common indications. It is a methodological proposal without a patient series; Level of Evidence IV.

Sections of note

Injection sites categorised as dorsal, paramedian, tip and endonasal.
Indications covered: droopy nose, dorsal hump, saddle deformity, inverted-V deformity, tip abnormalities, twisted nose, post-surgical dorsal irregularity, internal nasal valve dysfunction.
A conservative dosing approach is recommended for natural results and fewer complications.
Endonasal injection is included as a site category.

What it means for a patient

Filler rhinoplasty is being organised into named protocols rather than left to individual habit.
Conservative volumes are advised; more filler is not better.
No outcome data support this particular protocol in the abstract.

Why this paper matters

It is one of several attempts to standardise liquid rhinoplasty from a group that also works in endoscopic surgery. Limits: no data, expert proposal.

Terms

Liquid rhinoplasty: another name for filler rhinoplasty.
Paramedian: beside the midline.
Inverted-V deformity: a visible V-shaped shadow where the nasal bones meet collapsed upper lateral cartilages after hump removal.
Saddle deformity: a sunken bridge.
Internal nasal valve: the narrowest part of the nasal airway.

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

Abstract

Background: Liquid rhinoplasty, a non-surgical procedure using hyaluronic acid (HA) to reshape and refine the nose, has gained in popularity as an alternative to traditional surgical rhinoplasty although its results are not definitive. However, the lack of standardized injection protocols has raised concerns about treatment consistency and patient safety.

Objectives: In this article, the authors propose a systematic protocol for the most common indications of liquid rhinoplasty.

Methods: By adopting a standardized methodology, healthcare professionals can enhance patient safety, improve treatment consistency, and optimize patient satisfaction.

Results: The protocol includes standardized injection sites categorized as dorsal, paramedian, tip and endonasal injections. Specific injection areas are recommended for different nasal shapes such as droopy noses, dorsal humps, nasal saddle deformity, inverted V deformity, tip shape abnormalities, twisted noses, revision cases with dorsal irregularities, and internal nasal valve dysfunction. While variations in filler dosages may be necessary based on individual patient needs, a conservative approach is recommended to maintain natural-looking results and reduce the risk of complications.

Conclusions: The increase in non-surgical techniques for nasal refinement offers patients more options, and systematized injection protocols based on different nasal types provide a structured framework for liquid rhinoplasty.

Level Of Evidence Iv: 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 www.springer.com/00266 .

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