Standardized Non-surgical Rhinoplasty with Hyaluronic Acid: Consistent Outcomes Across Injectors with Varying Experience

Germani M, Roschel P, Rogerio V, Munoz-Lora VRM.

PubMed 41813985 Publisher (DOI)Free full text (PMC)

What this paper says

When 53 injectors of varying experience used the same standardised filler technique on 59 patients, filler volume, duration of effect and safety were the same across experience levels, but satisfaction was higher with more experienced injectors.

Overview

Complications from nasal filler are often blamed on inexperienced injectors. The Brazilian authors retrospectively analysed 59 non-surgical rhinoplasties performed by 53 injectors at one centre, recording age, BMI, hyaluronic acid volume per nasal subunit, injector experience, GAIS satisfaction and perceived duration of results.

Sections of note

Mean filler volume 0.45 mL (SD 0.15) per procedure, with no difference by experience (p = 0.374).
Median GAIS 1.0 (improved); satisfaction was significantly higher with more experienced injectors (p < 0.001).
Perceived duration 6-9 months regardless of experience (p = 0.117).
No serious or vascular adverse events.
Level of Evidence IV.

What it means for a patient

A standardised technique and suitable product produced safe results even from less experienced hands in this small series.
Experience still mattered for how pleased patients were with the result.
Fifty-nine patients is too few to detect rare vascular complications, so "no events" is not proof of safety.

Why this paper matters

It separates technique from injector experience, which is rarely done. Limits: retrospective, one patient per injector on average, single centre, small sample.

Terms

Non-surgical rhinoplasty: reshaping the nose with injectable filler.
Hyaluronic acid (HA): the most common filler material, a gel that the body can dissolve.
GAIS: Global Aesthetic Improvement Scale, rated from worse to very much improved.
Nasal subunit: an anatomical region of the nose such as radix, dorsum, tip or columella.
Vascular adverse event: filler blocking an artery, causing skin damage or vision loss.

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

Abstract

Background: Non-surgical rhinoplasty using hyaluronic acid (HA) fillers has become an increasingly popular alternative to surgical approaches. However, concerns persist regarding adverse events, particularly when procedures are performed by less experienced injectors.

Objectives: This study aimed to evaluate perceived outcomes of non-surgical rhinoplasty with HA according to the injector's clinical experience level, and to investigate whether experience influences aesthetic satisfaction, safety, product volume used, or perceived treatment duration.

Methods: This retrospective, single-center study analyzed 59 patients who underwent non-surgical rhinoplasty using HA, performed by 53 injectors with varying clinical experience levels in non-surgical rhinoplasty. Data were collected on age, BMI, volume of HA injected per nasal subunit, injector experience, aesthetic satisfaction using the Global Aesthetic Improvement Scale (GAIS), and perceived duration of results. Statistical analyses included Kruskal-Wallis tests, Spearman correlations, linear regression, and ordinal logistic regression.

Results: The mean total volume of HA injected per procedure was 0.45 (± 0.15) mL, with no significant differences across experience levels (p = 0.374). The overall median GAIS score was 1.0 (IQR: 1.0), indicating improvement, with significantly higher satisfaction among patients treated by more experienced injectors (p < 0.001). Perceived duration of results was 6-9 months with no significant differences by injector experience (p = 0.117). No serious or vascular adverse events were reported.

Conclusions: Non-surgical rhinoplasty with HA may provide favorable outcomes across injector experience levels when performed with a standardized technique and an appropriate product. Greater clinical experience correlated with higher patient satisfaction but not with filler volume or duration of effect.

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).