Nonsurgical Correction of Surgical Rhinoplasty Complications with Hyaluronic Acid Fillers: A Retrospective Review of 2088 Cases

Harb A, Abdul-Razzak A.

PubMed 39247575 Publisher (DOI)Free full text (PMC)

What this paper says

Across 2088 patients treated with hyaluronic acid filler to correct problems after surgical rhinoplasty, median satisfaction was 9 out of 10 and three patients developed skin tissue death, all of which resolved.

Overview

Surgical rhinoplasty has a significant revision rate, and revision surgery is itself difficult. Filler injection offers correction at lower cost with less downtime. The authors present one injector's experience with nonsurgical revision, reviewing charts of patients aged 18 and over treated between March 2018 and August 2022, with data collected up to a year after the first injection.

Sections of note

Design: retrospective chart review, 2088 patient cases, single injector.
Most common reasons: bridge collapse or asymmetry 49.0 percent, an under-projected tip 44.0 percent, surface irregularity or scarring 35.4 percent.
Mean filler volume at the first treatment: 0.49 millilitres. Median satisfaction immediately after treatment: 9 on a 1 to 10 scale.
Most common adverse event at the 2 week visit: redness in 36.4 percent.
Three patients developed skin necrosis, all transient and self resolving, reported as 0.47 percent. Note that 3 of 2088 is 0.14 percent, so the stated percentage does not match the case total.
Stated conclusion: this should be considered before surgical revision.

What it means for a patient

Filler can camouflage the specific problems that follow surgery, notably a collapsed or uneven bridge and a dropped tip, without another operation.
It adds volume, so it can fill a hollow or hide a step but cannot remove excess or reposition structures.
Skin necrosis occurred in three patients and all recovered, but it is the serious risk of nasal injection, especially in a previously operated nose where blood supply is already altered.
Limits: retrospective, one injector, no comparison against surgical revision, no stated durability, and follow up to one year.

Why this paper matters

Revision rhinoplasty is among the hardest operations, and many patients seeking it need only a small contour correction. A series of this size documents that filler can serve that role and quantifies the risk. Whether the correction lasts, and how repeat treatment behaves over years, is not addressed.

Terms

Nonsurgical rhinoplasty: reshaping the nose by injecting filler instead of operating.
Hyaluronic acid filler: an injectable gel made from a sugar molecule present in tissue.
Vascular occlusion: filler blocking a blood vessel, which can cause tissue loss or blindness.
Necrosis: death of skin or soft tissue, usually from lost blood supply.
Erythema: redness of the skin.
Revision rate: the proportion of patients needing a further procedure.

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

Abstract

Background: Surgical rhinoplasty is a highly complex cosmetic procedure with significant revision rates. Unfortunately, surgical revision rhinoplasty is associated with many challenges. Nonsurgical correction of surgical rhinoplasty complications with injectable hyaluronic acid fillers is an alternative with less cost and downtime. In this article, we present the first author's experience with 2088 cases of nonsurgical revision rhinoplasty, including technical considerations, patient-reported outcomes, and adverse events.

Methods: A retrospective chart review was completed on patients 18 years and older who received nonsurgical rhinoplasty treatment between March 2018 and August 2022. Patient demographic data, and data on indications for treatment, volume of filler used, patient-reported satisfaction, and adverse events (including erythema, infection, vascular occlusion, and necrosis) were collected up to 1 year after the initial injection.

Results: A total of 2088 patient cases are included in this study. The most common indications for treatment included bridge collapse or asymmetry (49.0%), an under-projected tip (44.0%), and surface irregularity/scarring (35.4%). The mean volume of filler used at initial treatment was 0.49 mL (SD 0.19). Median patient satisfaction immediately after treatment was 9 (visual analog scale ranging from 1 to 10). The most common adverse event reported at the 2-week follow-up was erythema (36.4%). Three patients presented with skin necrosis (0.47%). All three of these were transient and self-resolving.

Conclusions: Nonsurgical correction of rhinoplasty complications with hyaluronic acid fillers can be a safe, minimally invasive option with high patient satisfaction and immediate and predictable results. This should be considered first line before surgical revision.

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