"Functional Rhinofiller": Improvement of Nasal Airflow with Rhinofiller-A Retrospective Review.

INTRODUCTION: Rhinofiller is an aesthetic medical technique that can significantly enhance facial aesthetics by employing hyaluronic acid infiltration. The aim of this study is to review the impact of aesthetic rhinofiller on nasal airflow. METHODS: This is a retrospective review of 63 consecutive patients. The evaluation of the change in nasal respiratory flow was performed subjectively using a Likert questionnaire and objectively using a rhinomanometer, which enabled active anterior rhinomanometry (AAR). Data were collected at pre-intervention, post-intervention, and at 6-month follow-up. RESULTS: Among the 63 patients, the questionnaire responses resulted statistically significant both after the treatment and at the 6-month follow-up (p=0.00001). A statistically significant improvement was also observed at the rhinomanometric evaluation between pre-intervention and post-intervention (p=0.006 at 74 Pa, p=0.002 at 100 Pa, and p=0.001 at 150 Pa) and at the 6-month follow-up (p=0.008 at 74 Pa, p=0.003 at 100 Pa, and p=0.002 at 150 Pa). Differences between results were established with a Student's t-test. All p-values were two-tailed, and a value < 0.05 was considered significant. CONCLUSIONS: Rhinofiller can be a valuable aid in enhancing both nasal airflow and facial aesthetics. Based on our experience, it resulted in an immediate post-operative improvement in nasal airflow that remains stable in the subsequent 6 months. 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 . IV: Non-Surgical Procedures.

The Use of Cross-Linked Hyaluronic Acid in Non-surgical Rhinoplasty Using Italian Technique.

INTRODUCTION: Projection and upper rotation to the tip is fundamental in the nasal rejuvenation, as a matter of fact the tip is the most important and has strongly effects on the improve appearance and quality of life. The aim of the present study was to evaluate reshaping the tip of the nose by cross-linked hyaluronic acid using Italian technique. METHODS: In a period between November 2019 and 2023, a total of one hundred and forty healthy, 95 females and 45 man patients, were performed with a mean age 44±5 (age range: 31-52 years old) affected by tip of congenital (22) or ageing nose hypotonia (118), and reduced volume that need of an elevation of the nose tip. The anatomic markers have been considered for the anthropometric measurements after the filler rhinoplasty. Two infiltrations were performed, one in the infiltration into the antero-caudal access over the columella produce upward rotation of the tip of the nose and second infiltration into the antero-superior access produce the projection of the tip of the nose. Medical device used in the study was Neofound STRUCT LIDO (LOVE COSMEDICAL srls-Via Toniolo 9, 57022 Castagneto Carducci, ITALY) containing sodium hyaluronate/hyaluronic acid high molecular weight (1.500

Rhinofiller: Fat Grafting (Surgical) Versus Hyaluronic Acid (Non-surgical).

We conducted a thorough examination of the paper titled " Rhinofiller: Fat Grafting (Surgical) Versus Hyaluronic Acid (Non-surgical)" authored by Gentile et al. in Aesthetic Plastic Surgery with significant interest. The author shared their practical insights gained from employing "fat grafting" and "hyaluronic acid" methods for nasal remodeling in a randomized controlled trial. The research is notably captivating and executed with commendable proficiency. However, we do hold specific reservations concerning the methodologies employed. Precise understanding of the properties of the active substances utilized is fundamental for any medical intervention, and standardization stands as a pivotal element. It is essential to grasp the core characteristics of the administered HAs to potentially uncover links between these attributes, resulting outcomes, and possible complications. In the context of tissue volumization using fillers, rheology-an investigation into material flow and deformation under stress-holds particular importance. Gaining a comprehensive understanding of HA's rheological properties is imperative, especially when selecting an appropriate dermal filler for nasal applications. Among the critical properties of HA are viscosity, elasticity, and cohesiveness. While acknowledging the valuable contributions made by the authors, it is imperative that further analysis takes into account these influential factors during the course of their investigation. LEVEL OF EVIDENCE V: 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 .

Rhinofiller: Fat Grafting (Surgical) Versus Hyaluronic Acid (Non-Surgical).

BACKGROUND: The author presented his experience using "fat grafting" (FG) and "hyaluronic acid" (HA) techniques in nasal remodeling. OBJECTIVES: The paper aimed to evaluate the efficacy and safety of the use of FG and HA in nasal remodeling for aesthetic improvement. METHODS: A randomized controlled trial was conducted. 15 patients affected by soft defects of the dorsum, low and boxy nasal tip, and hidden columella, were treated with FG (study group-SG), comparing results with the control group (CG) (n = 17) treated with hyaluronic acid (HA). Post-operative follow-up took place at 1, 2, 4, weeks, 3, 6, 12 months, and then annually. RESULTS: 73.7% of SG patients showed excellent cosmetic results after 1 year compared with only 29.7% of CG patients. At one-month, major part of people who underwent the treatments (FG and HA) referred to satisfaction with the resulting volume contours (p = 0.389). 88.3% of CG patients versus 53.8% of SG described the HA and FG injection, respectively, as a very comfortable and non-invasive procedure. As expected, patient satisfaction with the appearance of nasal contouring was higher in the FG group at 1 year. CONCLUSIONS: FG and HA were safe and effective in this series of cases performed. LEVEL OF EVIDENCE III: 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.

Non-surgical rhinoplasty technique: An innovative approach for nasal reshaping with hyaluronic acid fillers.

OBJECTIVE: Nonsurgical rhinoplasty has become increasingly popular among patients who want to improve the aesthetic aspects of their nose and do not accept the risks and/ or cost of surgical rhinoplasty. The main goal of the current paper was to present the preliminary aesthetic and clinical outcomes of an innovative injection technique for nose sculpturing with hyaluronic acid (HA) filler. METHODS: Retrospective analysis of a prospective clinical registry of patients who attended one of the study centers and were candidates for non-surgical nose reshaping between October 2019 and November 2020. A 25 mg/mL HA filler was administered, in all the cases, by using a syringe with a fixed microneedle (30G/8mm). All patients were injected at three key nose points with the following order: (1) Tip (maximum HA injected 0.2 mL); (2) columella (maximum HA injected 0.3 mL); and (3) Radix and Dorsum (maximum HA injected 0.3 mL). Degree of patient satisfaction with the treatment was assessed by using a five-points Likert scale. The primary endpoint was the degree of patients' satisfaction 12 months after treatment. RESULTS: One-hundred-and-one patients (91 women) were included in the study. Fifty-six (56%) patients underwent a unique treatment-session and 44 (44%) subjects needed an additional touch-up. Eighty-five (84.2%) patients were very satisfied with the treatment results. Six (5.9%) patients reported moderate adverse events, which were successfully controlled with medical therapy. CONCLUSIONS: Our nose sculpturing technique, by using hyaluronic acid filler, was an effective, predictable, and relatively safe procedure, that obtained a high degree of patient satisfaction.

An Innovative Approach for Nasal Reshaping using Hyaluronic Acid Intradermal Injections.

Background: Nasal reshaping using hyaluronic acid (HA) filler has become a widespread technique and injections are usually performed in deep layers. As an alternative, we propose an innovative approach where HA is injected into the dermis, the so called MesoRhinoFiller. Aims and Objectives: The aim of this study was to describe our injection technique using a smooth, cohesive, and slightly viscous HA filler injected in the dermis. Materials and Methods: A retrospective review of the author's clinical experience from March 2017 to March 2020 was presented. A total of 280 consecutive patients were treated with HA injections to improve their nasal appearance. The mean volume was 0.5 cc HA filler/treatment. Results: An average increase of 4.9 ± 3.4° was obtained for the nasofrontal angle, and of 7.0 ± 4.5° for the columella labial angle. Asymmetries in the nasal profile and alar rim were also corrected. All the patients were satisfied with the results and no complications occurred. Conclusion: Injecting HA fillers in the dermal plane is a versatile approach that provides very satisfactory results. This technique allows one to better correct aesthetical, post-traumatic, and post-surgical defects compared with the usual injection rhinoplasty procedures where the filler is injected deep onto the bone/cartilage in the midline of the nose.

The longevity of the nonsurgical rhinoplasty: A literature review.

INTRODUCTION: Non-surgical rhinoplasty is one of the terms used to describe the technique of injecting fillers into the nasal pyramid region for aesthetic, and sometimes functional, purposes. Although it is now an extremely popular practice, the techniques proposed and the products used are different. This inhomogeneity is also found regarding the treatment longevity. METHOD: A literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). It was realized to collect information on this disputed topic. Pubmed/MEDLINE database was explored. RESULTS: A total of 228 articles were extracted from the basic literature search. 81 of these were excluded based on the content of the title and abstract. All 147 remaining articles were submitted for full-reading. 49 of these were excluded because the injection product used by the authors was not a hyaluronic acid based filler; while 82 of these were excluded because they provided no indication regarding the longevity of the treatment. Of the 16 selected studies, according to six authors, the duration of treatment is therefore between 8 and 12 months. For all the others, instead, the results seem to last longer than this period. The longest time interval was 8 years. DISCUSSION AND CONCLUSION: Establishing with certainty the longevity of non-surgical rhinoplasty seemed to be extremely complex. In the light of this discordant data seems to be essential to deepen the argument. A study using imaging techniques and/or standardized photographic material appears essential to further investigate this controversial topic.

Rhinofilling with hyaluronic acid thought as a cartilage graft.

INTRODUCTION: There is great demand for nonsurgical aesthetic procedures. In this case series, the authors describe their stepwise technique of injecting hyaluronic acid (HA) into the nose to yield pleasing, stable results. CASE SERIES: A total of 148 patients underwent minimally invasive rhinoplasty by injection of HA filler. Anatomic contraindications for the procedure were a large dorsal hump, extreme tip projection, or excessive nasal deviation. HA injections were made in a specific order to reshape and stabilize the nose; the surgical plan was conceptually similar to placement of cartilage grafts. Patients indicated their satisfaction with the surgical results on a visual analog scale. Immediately after the procedure, all patients had transient redness and slight swelling at the injection site; this resolved spontaneously by 24 h posttreatment. Vascular impairment developed in 1 patient and was managed with hyaluronidase. In general, patients expressed a high level of satisfaction. Thirty-two patients returned for a "touch-up" filler injection 1 year posttreatment. DISCUSSION: Nasal reshaping by HA injection can be carried out quickly, safely, and effectively with minimal patient discomfort or downtime. Care must be given to select patients who are indicated for this procedure, and meticulous pretreatment planning is necessary.

Safety and Early Satisfaction Assessment of Patients Seeking Nonsurgical Rhinoplasty with Filler.

BACKGROUND: Nonsurgical aesthetic treatments are usually preferred by patients because their effects are visible immediately after the treatment and patients can return to their normal activities on the same day. Although many studies have indicated safety and efficacy of filler injection to improve facial appearance, it is not absolutely confirmed for nose reshaping. OBJECTIVES: To assess the safety and early satisfaction of 52 consecutive patients underwent nonsurgical rhinoplasty with an injection of a 20-mg/mL smooth, cohesive, and viscous hyaluronic acid (HA) filler. MATERIALS AND METHODS: Fifty-two consecutive healthy patients, dissatisfied with the appearance of their nose, were treated with HA injections between November 2014 and November 2016. Complications and side effects were documented. Aesthetic outcomes were scored subjectively on a scale of 1-4 represented by four emoticons. RESULTS: Among patients, 96.15% affirmed to be "very satisfied" at the end of the procedure (50 patients over 52 treated). No major complications and side effects occurred. CONCLUSIONS: Outcomes of this study, with the limitation of a non-comparative open-label study, show that surgical remodeling of the nose, with the use of a 20-mg/mL smooth, cohesive, and viscous HA filler, is a safe and predictable technique, with a high degree of satisfaction for the patients.