A Cannula-Based Sequential Injection Protocol for Non-surgical Rhinoplasty in East Asian Patients

Ye J, Wang X, Yi K, Zou P, Liu H.

PubMed 42443422 Publisher (DOI)Free full text (PMC)

What this paper says

In 528 East Asian patients injected with firm hyaluronic acid filler in a fixed tip-then-dorsum-then-glabella sequence by cannula, 3D scans showed 3.69 mm more tip projection and 2.62 mm more length at 9 months, with no vascular complications.

Overview

Filler rhinoplasty is popular in East Asia but lacks a standard protocol. Two centres retrospectively reviewed patients treated from 2020 to 2024 with a high-G' hyaluronic acid filler delivered by cannula: first the tip via deposition in the fibrous septum, then the dorsum, then the glabellar triangle. Outcomes were FACE-Q scores and 3D facial scanning (MVS-N1) before and at 9 months.

Sections of note

528 patients (490 women, 38 men), mean age 27.7.
In the 426 who had the full three-site protocol: nasal length +2.62 mm, tip projection +3.69 mm, nasolabial angle +5.7 degrees, nasofrontal angle -9.4 degrees (all p < 0.001).
FACE-Q across all 528: satisfaction +44.4, social function +26.2, psychological well-being +28.1, distress -39.4 (all p < 0.001).
No vascular complications; 11 cases of transient redness that resolved.
Level of Evidence IV.

What it means for a patient

A structured filler protocol produced measurable shape changes and large satisfaction gains at 9 months in this series.
The absence of vascular complications in 528 patients is notable, since filler blindness and skin necrosis are the main risks of nasal filler; cannula use and technique are credited.
Filler is temporary and the study stops at 9 months.

Why this paper matters

It is a large, objectively measured series that standardises a common but variable procedure. Limits: retrospective, two centres, one filler product, 9-month endpoint.

Terms

Non-surgical rhinoplasty: reshaping the nose with injectable filler.
Cannula: a blunt-tipped tube used to place filler with less risk of entering a blood vessel than a sharp needle.
High-G' filler: a firm, lift-capable hyaluronic acid gel.
Glabella: the area between the eyebrows above the nose root.
FACE-Q: a validated patient-reported outcome questionnaire for facial aesthetics.

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

Abstract

Introduction: Non‑surgical rhinoplasty is increasingly popular for nasal augmentation in East Asian patients. However, a standardized, anatomy‑driven protocol for the sequential and layered correction of the nasal tip, dorsum, and glabellar complex-key aesthetic units in the Asian nose-is still lacking.

Materials And Methods: In this dual‑center retrospective study, 528 East Asian patients (490 females, 38 males; mean age 27.7 years) underwent non‑surgical rhinoplasty between 2020 and 2024. A high‑G' hyaluronic acid filler was injected via cannula in a predefined sequence: first, the nasal tip via fibrous septal deposition; followed by the dorsum and glabellar triangle. Outcomes were assessed using ·FACE‑Q and 3D facial scanning (MVS‑N1) preoperatively and at 9 months.

Results: Three‑dimensional analysis of the 426 patients who received the full three-site protocol showed significant improvements from baseline in nasal length (+ 2.62 mm), tip projection (+ 3.69 mm), nasolabial angle (+ 5.7°), and nasofrontal angle (- 9.4°) (all p < 0.001). FACE‑Q scores significantly improved across all 528 patients in satisfaction (+ 44.4 points), social function (+ 26.2), psychological well‑being (+ 28.1), and reduced distress (- 39.4) (all p < 0.001). No vascular complications occurred; 11 cases had transient erythema that resolved spontaneously or with conservative measures.

Conclusion: The sequential "tip‑dorsum‑glabella" injection protocol, featuring a refined cannula‑based technique for fibrous septal tip augmentation, was associated with a low complication rate and significant short‑term improvements in patient‑reported and anthropometric outcomes in this retrospective analysis, suggesting that it is a clinically feasible approach for non‑surgical rhinoplasty in East Asian patients.

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).