Secondary Liquid Rhinoplasty: Challenges, Techniques, and Long-term Outcomes

Overview

Non-surgical rhinoplasty with hyaluronic acid filler is increasingly used to smooth irregularities after surgery. The authors reviewed prospectively documented records from one private plastic surgery practice from December 2004 to February 2025, including only post-rhinoplasty patients with at least six months of follow-up after filler. They describe anatomical targets, injection planes and filler selection.

Sections of note

• 1,122 post-surgical rhinoplasty patients received filler correction.
• Overall complication rate 2.8%; all adverse events were minor and transient.
• Patient-reported satisfaction 92%.
• Records span more than 20 years in a single practice.
• Level of Evidence 4.

What it means for a patient

• Small dents, asymmetries or residual humps after rhinoplasty can often be camouflaged with filler instead of a second operation.
• In this series, serious complications did not occur, but operated noses have altered blood supply, and the authors stress "surgical insight" in injector selection.
• Filler is temporary and does not restore structure; it is a camouflage tool.

Why this paper matters

It is by far the largest reported series of filler correction after surgical rhinoplasty. Limits: single practice, retrospective, no control group, satisfaction self-reported, and minimum follow-up only six months.

Terms

• Non-surgical (liquid) rhinoplasty: reshaping the nose with injectable filler.
• Dermal filler: a gel, usually hyaluronic acid, injected under the skin to add volume.
• Rheology: the flow and stiffness properties of a filler, which determine where it can be used.
• Injection plane: the tissue layer the filler is placed in, which affects safety and result.