Nonsurgical Rhinoplasty: An Updated Systematic Review of Technique, Outcomes, Complications, and Its Treatments

Song D, Wang X, Yu Z.

PubMed 38862661 Publisher (DOI)Free full text (PMC)

What this paper says

Across 30 studies and 9,657 filler rhinoplasty patients, satisfaction was 99.08%, 39.11% had some complication (mostly redness and swelling), and 0.27% had an arterial occlusion.

Overview

The Chinese authors searched PubMed, Embase and Cochrane, screened 1,812 records and included 30 studies, extracting filler materials, sites, technique, satisfaction, complications and their treatment.

Sections of note

9,657 patients; hyaluronic acid in 96.76%, calcium hydroxyapatite in 1.22%.
Overall satisfaction 99.08%.
Overall complication incidence 39.11%; erythema and swelling 27.95%.
Severe complication (arterial occlusion) in 0.27%, with consequences including blindness, skin necrosis and stroke.
Level of Evidence IV.

What it means for a patient

Roughly 1 in 370 patients in the pooled data had a blocked artery, the complication that can cause blindness or skin loss.
Minor redness and swelling are common and expected.
Satisfaction figures this high reflect short-term self-report in mostly retrospective studies.

Why this paper matters

It is the largest pooled estimate of filler rhinoplasty complication rates, and its 0.27% figure for vascular events is widely cited. Limits: heterogeneous observational studies, likely under-reporting of severe events, no follow-up standardisation.

Terms

Non-surgical rhinoplasty: reshaping with injectable filler.
Calcium hydroxyapatite (CaHA): a firmer, longer-lasting filler that cannot be dissolved with hyaluronidase.
Arterial occlusion: filler blocking an artery.
Erythema: redness of the skin.
Cerebral infarction: a stroke caused by filler reaching the brain's circulation.

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

Abstract

Background: For patients looking for temporary results or who do not want surgery, nonsurgical rhinoplasty using filler injections has become increasingly popular. Filler materials and surgical techniques have improved in recent years, but serious complications remain. Therefore, the aim of this systematic review is to summarize the common types of fillers and injection techniques, complications, and treatment to help clinicians perform in a safer and more effective way.

Methods: A systematic review was performed using keywords and Medical Subject Headings search terms. PubMed, Embase, and the Cochrane Library were searched using the appropriate search terms. Data collected from each study included injection materials, location, technique, patient satisfaction and complications, and treatment.

Results: From the 1812 studies identified, 30 were included in the systematic review. A total of 9657 patients underwent nonsurgical rhinoplasty, most commonly with hyaluronic acid (HA) (96.76%), followed by calcium hydroxyapatite (CaHA) (1.22%). Overall satisfaction was 99.08%. The overall incidence of complications was 39.11%, with the highest incidence of erythema and swelling (27.95%). Most of the complications are mild, but there are still 0.27% of the patients who have undergone severe complication-an arterial occlusion.

Conclusions: Nonsurgical rhinoplasty is an effective and relatively safe option for improving the profile of the nose, with a short operative time and high patient satisfaction. Most of the complications were mild, but still serious vascular complications such as blindness, skin necrosis, and stroke were as high as 0.27%. A thorough understanding of the anatomy of the nasal vessels and a precise surgical technique is an important basis for prevention. A BULLET POINT LIST: (1) We summarize the common types of fillers and injection techniques, complications, and treatment of complications to guide physicians to perform nonsurgical rhinoplasty in a safer and more effective manner. (2) Out of 1812 studies through the search strategy, 30 articles were included in the systematic review. A total of 9657 patients underwent nonsurgical rhinoplasty. (3) Nonsurgical rhinoplasty is an effective and relatively safe option to improve the profile of the nose, with a short surgical time and high patient satisfaction. (4) Most of the complications were mild, but some severe complications due to the vascular factors such as blindness, skin necrosis, and cerebral infarction need to be vigilant.

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).