Five‐point liquid rhinoplasty: Results from a retrospective analysis of a novel standardized technique and considerations on safety

Abstract

Background: Nonsurgical aesthetic improvement of the nose with hyaluronic acid (HA) fillers is becoming increasingly popular but comes with important safety considerations. Aims:To assess the safety and effectiveness of the standardized "five-point liquid rhinoplasty" approach.Methods: This was a retrospective, single-center analysis of consecutive adult patients undergoing nonsurgical aesthetic treatment of the nose. All had one of the three main indications (insufficient nasal projection, nasal hump, or deep glabella) and were injected using HA fillers with high elastic modulus. Treatments were given using some or all of the injection points of the "five-point liquid rhinoplasty" technique: P1 (nasal tip, 0.2-0.3 ml supracartilaginous); P2 (nasal root, 0.1-0.2 ml supraperiostal); P3 (cartilaginous dorsum, 0.1-0.2 ml supracartilaginous/supraperiostal); P4 (subnasal, 0.1-0.2 ml supraperiostal); and P5 (nasal alar, 0.1-0.2 ml per side supraperiostal). The risk of complications was minimized by injecting deep and staying in the midline as far as possible.Results: Twenty patients were enrolled (n = 15 female [75%]; mean age: 37.8 ± 11.7 years). The mean volume of filler used was 0.66 ± 0.35 ml per patient.Nineteen subjects (95%) said they were "very satisfied" with results, and the physician was also "very satisfied" with outcomes in 19 patients (95%). Two individuals experienced hematoma, which was managed conservatively; there were no other significant complications. Conclusions:The "five-point liquid rhinoplasty" is a simple and effective method designed to maximize safety. It offers a good alternative to surgery in selected patients.

Nonsurgical rhinoplasty using the hyaluronic acid filler VYC‐25L: Safety and patient satisfaction in a retrospective analysis of 492 patients

“…Alongside the methods described here, various different approaches to treating the nose have been proposed. 4,9,[24][25][26] As well as minimizing the risk of complications, these may improve the reproducibility of results and thus help to optimize patient satisfaction.…”

“…The nose has classically been regarded as a difficult area to treat with fillers, owing to the high degree of skin tension over underlying bone and cartilage, creating significant compressive forces that led to loss of projection with previous generations of HA fillers. 3,4 Hence, surgical rhinoplasty has long been considered the gold standard. However, this paradigm is beginning to change with the advent of HA fillers that have greater cohesivity and increased elastic modulus (G′)-providing enhanced lift capacity, more resistance to deformation, and reduced lateral spread, thus allowing vertical projection to be maintained over time.…”

“…6,7 In addition, several recent "real world" studies have shown that VYC-25L is safe and effective for aesthetic improvement of the nose, based on standardized approaches to treatment. 4,8,9 However, these studies included only modest numbers of patients. Given the risks associated with filler-based nasal treatment-particularly relating to rare but potentially devastating complications like necrosis and blindness 10,11 -it is important to evaluate the safety profile in large patient cohorts treated in routine practice.…”

“…The nose has classically been regarded as a difficult area to treat with fillers, owing to the high degree of skin tension over underlying bone and cartilage, creating significant compressive forces that led to loss of projection with previous generations of HA fillers 3,4 . Hence, surgical rhinoplasty has long been considered the gold standard.…”

“…In a prospective, randomized, controlled trial of patients requesting chin and jaw restoration, VYC‐25L treatment was associated with increased Global Aesthetic Improvement Scale scores and durable responses on the FACE‐Q Satisfaction and Psychological Well‐Being Scales 6,7 . In addition, several recent “real world” studies have shown that VYC‐25L is safe and effective for aesthetic improvement of the nose, based on standardized approaches to treatment 4,8,9 . However, these studies included only modest numbers of patients.…”