Advances of Hyaluronic Acid Nasal Injection Techniques

It has a complex network of blood vessels, and injecting filler into or near these vessels can cause serious complications, including skin necrosis or even vision problems in rare cases. Keep in mind that liquid rhinoplasty requires repeat treatments to maintain results (every 9 to 24 months depending on filler choice). When comparing costs to surgical rhinoplasty, consider the total investment over several years. Nonsurgical rhinoplasty is a cosmetic procedure that involves injecting fillers, such as HA, into the nose.
Published rates for revision rhinoplasty range from 9% to 20%.16, 17 For these patients, correction of minor iatrogenic deformities can produce desirable results while avoiding a second surgical procedure. In some cases, the collagen stimulation triggered by filler can provide stable, long‐term results that obviate the need for both revision surgery and repeated injections (Figure 2). Duration of effect for 超声刀英文 HA products is reported to range from 6 months to 18 years depending on the product and site of injection. However, in the nose, multiple authors report duration of treatment up to 8 years after a single injection.7, 8, 9, 10 Wang et al.11 demonstrated that injection of cross‐linked HA stimulates de novo production of Type I collagen in the skin. This may account for longer‐term results observed after placement of dermal filler.

Gadallah et al reported high patient satisfaction following cosmetic surgery and lipofilling in 50 women who had permanent dermal fillers removed [98]. Despite its safety, autologous fat grafting can lead to complications, including hematomas, scar formation, fat necrosis, cysts, contour irregularities, cellulitis, and cerebral embolism [99–102]. These severe risks are highly technique-dependent, underscoring the need for standardized protocols. PMMA is a permanent, non-degradable soft tissue filler that historically saw limited use because of the risk of delayed, stubborn granulomas. However, advancements in fabrication processes have improved PMMA microspheres, giving them a rounded shape and smooth surface that significantly reduces the likelihood of immune reactions and granuloma formation [79,80]. Artecoll (Canderm Pharma Inc), composed of 80% bovine collagen and 20% PMMA, became the only FDA-approved nonabsorbable filler in 2006.
Chemical peels, laser resurfacing, full-field ablative treatments, non-surgical skin tightening, and related technologies are central to this shift. A smoother, brighter, healthier look often crosses cultures more easily than one fixed structural ideal. Middle Eastern beauty ideals often value expressive eyes, a strong yet harmonious nose, fuller lips, balanced chin projection, and overall facial dignity rather than over-softening. Cultural consensus work cited in the literature notes clear regional preferences that differ from Western default formulas. This is one reason ethnic rhinoplasty and identity-preserving facial planning remain so important.

These include infection, tissue damage, or vascular compromise, such as vascular occlusions. However, these adverse events are rare when performed by an experienced practitioner. Allergic reactions to dermal fillers in non-surgical rhinoplasty are possible but extremely rare. Most modern fillers are made from hyaluronic acid (HA), a substance naturally found in our bodies.
Use of any dermal filler in the nose is off‐label and patients should be advised accordingly. Whatever injection devices are preferred by individual practitioners, it is important to systematize and standardize the overall approach. Prior to treatment, patients were asked to remove makeup and wash their face thoroughly, and the nose and surrounding area were cleansed with chlorhexidine. Five key areas were injected as needed—the radix, rhinion, columella, supratip, and tip—with the use of individual points customized according to the specific indication. The order in which they were injected was also determined on a case‐by‐case basis. Injections were made deep to the perichondrial/periosteal plane using a 30G needle (radix, rhinion, and supratip) or 25G cannula (columella and tip).
The tingling sensation was intense, giving me a sense of security that I wouldn't feel a thing. With this technique, a puncture is made with a 22-gauge (G) needle in the central region of the nasal tip in order to introduce the 22G cannula (Figure 9). First, the introduction is made toward the nasal bone crest, passing the septum to reach the lower part of the columella. In our patients, the filler is applied with a bolus technique on the bony crest after a retroinjection into the tip. Clinical observations suggest that comparable  improvement observed in the threads + BTX group and Threads + HA filler group may be explained by the recurrence of the nasal hump 1 year after treatment.

3D volumetric assessments (64%) showed HA persistence of 50–86% at 24 months and 60–86.4% at 12 months, with one study reporting 6–9 months. Ultrasound (20%) indicated 12–36 months persistence; MRI (8%) and profilometry (4%) reported presence up to 12 months. Patient-reported satisfaction, measured via subjective scales, aligned with objective findings, declining alongside quantitative HA volume over time.
Photoconsent was provided by individuals whose photos appear in this article. Besides treating patients, Alisha is also a researcher and educator at Dr Tim Ltd, a renowned aesthetics training company. She develops courses that trains thousands of medical practitioners each year on the latest techniques and safety practices. Non-surgical rhinoplasty primarily addresses cosmetic concerns by enhancing shape and symmetry. It cannot resolve underlying functional problems like breathing difficulties caused by structural issues in the nose. When considering a liquid nose job, it’s important to select a reputable clinic that adheres to strict hygiene practices.
As the specialty further evolves, however, concerns regarding data privacy, algorithmic bias, and regulatory gaps must be proactively addressed to ensure ethical and equitable use. We must have a shared call to action—clinicians, technologists, regulators, and ethicists must collaborate together to promote responsible innovation. Investment in diverse AI development, robust regulatory frameworks, and patient education will be instrumental in guiding this technological revolution. Clinics and developers must invest in transparency so that AI augments—rather than replaces—the human touch that remains at the center of aesthetic care. Ultimately, the future of aesthetic medicine is about achieving a balance—harnessing the analytical capability of AI without sacrificing the artistry, empathy, and customized judgment that characterize the specialty. By synthesizing innovative technology with human‐focused values, the field can create unparalleled opportunities, with advancements working not only toward aesthetic ideals but overall patient health.

Data indicate that PMMA-related complications occur at a rate of 4.9%, with granulomas at 1.9%; the incidence of granulomas is approximately 1 per 2075 patients annually, manifesting between 6 and 180 months after treatment. These findings suggest that the safety of PMMA as a filler is reliable when weighing the actual risks against the benefits [80]. Nonetheless, PMMA can cause adverse effects such as nodules and scarring, which respond minimally to corticosteroid injections. Its use should be rigorously weighed against the availability of safer, biodegradable alternatives for most aesthetic indications. Surgical intervention often yields better results in reducing these complications [83–85]. (1) We summarize the common types of fillers and injection techniques, complications, and treatment of complications to guide physicians to perform nonsurgical rhinoplasty in a safer and more effective manner.
Lips are more sensitive after lip filler treatment, and swelling may last up to 2 weeks. Overview of the complications of filler injection and management strategies. Common facial anatomy and injection sites and diagram of superficial musculoaponeurotic system (SMAS) structure. Also, transparency and patient education are essential to the building of trust in AI‐based care.

A cannula is blunt and flexible, which reduces the risk of penetrating a blood vessel directly. Many practitioners use a combination of both techniques depending on the zone. Neither approach entirely eliminates vascular risk — knowledge of anatomy and aspiration technique are more important than the instrument used. Nose filler refers to the use of a cosmetic treatment, most commonly a hyaluronic acid-based substance, to add volume and alter the shape of the nose. Hyaluronic acid is a naturally occurring substance found in the body’s connective tissue.
However, they also acknowledge that needles may be preferred in certain scenarios due to their ease of use and availability. The review concludes that while cannulas generally offer a safer alternative, the choice between the two should be guided by specific clinical contexts and practitioner expertise (Level IIb). Non-surgical rhinoplasty, often called a liquid nose job or non-surgical nose reshaping, has become one of the most searched aesthetic treatments in the UK over the past five years. If you are researching costs and want to understand what you are actually paying for before you book, this guide covers every option available in 2026 and how to plan your investment.