Revision Rhinoplasty After Non-Surgical Filler in East Asian Patients: A Safe and Effective Surgical Approach

Ye J, Wang X, Zhao H, Zou P, Xu Y, Wu M.

PubMed 40456990 Publisher (DOI)Free full text (PMC)

What this paper says

For East Asian patients whose noses were damaged by filler injections, a revision protocol of complete filler removal, rib cartilage, a septal "X" framework, rectus fascia and ePTFE dorsal augmentation improved tip and dorsal height and ROE scores at one year or more.

Overview

Filler rhinoplasty in Asia is often done with unknown materials and off-label techniques, producing "nasal disasters" that are hard to repair. The Chinese authors reviewed patients who had surgical revision after filler between June 2018 and January 2024, with at least one year of follow-up, analysing photographs for symmetry, shape and contour and recording ROE and VAS scores. Patient numbers are not given in the abstract.

Sections of note

Landmark heights at N (nasion), P and T (tip) points changed significantly, with notable increases at T and P.
The N-T line (nasal length) increased.
Postoperative ROE improved; median VAS score 2.
The protocol combined injection removal, costal cartilage, a septal X framework, rectus fascia dorsal modification and ePTFE elevation.
Level of Evidence V.

What it means for a patient

A nose distorted by filler can be surgically rebuilt, but it requires removing all injected material first and then a full structural reconstruction.
The repair used both the patient's own rib and a synthetic implant.
Patient numbers and complication rates are absent from the abstract.

Why this paper matters

It addresses a growing problem in East Asia, the surgical salvage of filler complications. Limits: numbers, follow-up detail and complications not reported in the abstract; Level V.

Terms

Non-surgical rhinoplasty: reshaping with injectable filler.
Costal cartilage: rib cartilage.
Septal X framework: a graft configuration crossing the septum for tip and length support.
Rectus abdominis fascia: the sheath of the abdominal muscle, used as a soft covering graft.
ePTFE: expanded polytetrafluoroethylene, a porous synthetic implant.

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

Abstract

Introduction: Recent advancements in non-surgical cosmetic technologies have increased their popularity for facial rejuvenation, particularly non-surgical rhinoplasty in the Asian region. However, variability in injection techniques, unknown injectable materials, and off-label use have led to complications, often referred to nasal "disasters," which complicate subsequent surgical repairs. Thus, safe and effective treatment strategies for nasal repair following non-surgical rhinoplasty are urgently needed.

Materials And Methods: This study systematically reviewed patients who underwent surgical revision rhinoplasty in East Asia from June 2018 to January 2024. During a follow-up period of at least one year, postoperative photographs were analyzed, and patients were re-evaluated for symmetry, nose shape, and contour.

Results: Significant changes were observed in the heights of the N, P, and T points, with notable increases in the T and P points. The length of the NT line increased, postoperative ROE scores improved, and the median VAS score was 2, indicating enhanced patient satisfaction.

Conclusion: Rhinoplasty revision surgery that combines complete injection removal, costal cartilage transplantation, a nasal septum 'X' framework, rectus abdominis fascia modification of the nasal dorsum, and expanded polytetrafluoroethylene (ePTFE) to elevate the nasal dorsum can achieve good, safe, and satisfactory results for patients who have undergone non-surgical filler rhinoplasty.

Level Of Evidence V: 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).