What are Dermal Fillers and Nose Lift?

Surgical rhinoplasty is still considered the gold standard in nasal aesthetics and correcting dysfunctions. However, high costs, long recovery times and potential complications keep many patients away from surgical procedures. At this point, nonsurgical (medical) rhinoplasty stands out as a nonsurgical and less invasive alternative.

What is Medical Rhinoplasty?
Medical rhinoplasty is a procedure that reshapes the nose by injecting dermal fillers between the nasal skin and cartilage or bone structures. It offers an effective alternative, especially in correcting minor deformities that occur after surgery, in patients who are not suitable for surgery or in individuals who do not want surgery.

Fillers: HA and CaHA
The most commonly used materials in nasal filling applications:

Hyaluronic Acid (HA): It is especially preferred because it is reversible (can be dissolved with hyaluronidase) and allows for revisions after the procedure.

Calcium Hydroxyapatite (CaHA): It is more permanent (~9-12 months) and stands out with its malleable structure. However, it is irreversible.

Physical properties such as viscosity (n*) and elasticity (G’) are critical for the filler to maintain its form. Products with high n* and G’ values ​​should be preferred for nonsurgical rhinoplasty.

Note: The hydrophilic properties of HA may increase the risk of edema and vascular occlusion in some cases. Therefore, correct product selection and injection technique are critical.

Indications
Medical rhinoplasty can be used to correct the following nasal defects:

Dorsal hump camouflage

Deep radix correction

Nasal tip ptosis

Saddle nose deformity

Columellar retraction

Nasophacial angle increase

Dorsal contour corrections

Asymmetry and alar retraction

Minor postoperative irregularities

This procedure is not effective for reducing a large nose, completely narrowing the nose, or correcting significant bony deformities.

Attention to Anatomy
A detailed knowledge of anatomy is essential for successful nasal filler application. The layers of the soft tissues of the nose, skin thickness, cartilage, and bone structures should be carefully evaluated. The deep fat layer located under the skin provides a suitable plane for filler and reduces vascular injury.

Vascular structures that require special attention:

Lateral nasal artery (branch of facial artery)

Dorsal nasal artery (branch of ophthalmic artery)

Columellar arteries (branch of upper labial artery)

Inferior alar artery

There is a risk of serious complications such as vascular occlusion, necrosis or, rarely, blindness due to arteriovenous anastomoses in these regions. Therefore, the use of cannula is recommended in injections.

Safety in Filling Techniques
A detailed patient assessment should be made before the application

The patient's anatomy should be analyzed clearly before the intervention

Slow injection and low volume should always be preferred

A cannula should be used to reduce the risk of intravascular injection

Hyaluronidase should be kept ready for emergencies

Combination with Botulinum Toxin
The effect of rhinoplasty can be strengthened by applying botulinum toxin to the Depressor Septi Nasi muscle, which causes depression of the tip of the nose. It creates synergy especially in injections made to lift the tip of the nose.

Conclusion
Medical rhinoplasty can provide successful, effective and safe results when performed with appropriate patient selection, correct technique and good anatomy knowledge. It should not be considered as an alternative to surgery, but as a complementary or temporary solution. Patient expectations should be managed realistically and surgical and medical options should be presented comparatively.