Complications of Nonsurgical Rhinoplasty with Hyaluronic Acid Injections: A Narrative Review.

[BACKGROUND] The increasing popularity of cosmetic procedures has led to a rise in both surgical and nonsurgical interventions. Rhinoplasty, particularly nonsurgical rhinoplasty using injectable fillers such as hyaluronic acid (HA), has become highly sought after due to its minimally invasive nature. Despite its benefits, complications can occur, ranging from minor to severe.

[METHODS] This narrative review adheres to PRISMA guidelines and evaluates the complications associated with injectable rhinofillers. A comprehensive search was conducted in PubMed and Embase databases for articles published between January 1, 1990, and September 30, 2023, using specific keywords related to nonsurgical rhinoplasty and its complications. A total of 180 articles were identified, with 80 included in the final review.

[RESULTS] Complications from injectable rhinofillers vary widely. Common early-onset issues include asymmetry, injection site reactions, and hypersensitivity. Severe complications like vascular occlusion can lead to tissue ischemia, necrosis, or even blindness. Infection, Tyndall effect, nodules, granulomas, scarring, and biofilms are also documented. The incidence of severe complications is relatively low but requires immediate and effective management to prevent long-term consequences.

[CONCLUSIONS] Nonsurgical rhinoplasty using fillers, particularly HA, is generally safe with a low risk of severe complications. Awareness and prompt management of potential complications are crucial for practitioners. Preventative measures, precise techniques, and thorough anatomical knowledge can mitigate risks, ensuring better patient outcomes.

[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.