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Page 10 of 13 Randall et al. Plast Aesthet Res 2024;11:18 https://dx.doi.org/10.20517/2347-9264.2023.115

In addition to the endonasal approaches, other modern techniques are gaining popularity in addressing
nasal tip contouring in a minimally invasive manner. Hyaluronic acid filler injections to sculpt the nose
have been suggested as a “Non-surgical rhinoplasty” technique for patients hoping to improve aesthetic
aspects of their nose without the risks and/or costs associated with surgical intervention [64,65] . Surgical fat
grafting has also been suggested as a less-invasive rhinofiller technique to approach boxy and asymmetric
nasal tips and has shown favorable results. One case series demonstrated that compared to hyaluronic
injection, fat graft injection as a rhinofiller for nasal sculpting resulted in longer-lasting favorable cosmetic
results for patients [66,67] . However, given the need to harvest autologous fat for injection, fat grafting for a
rhinofiller is a more involved surgical procedure and canbe less comfortable and more invasive for patients
[67]
than hyaluronic acid injection . While the more recent data are encouraging, it is unclear whether the
positive results of hyaluronic acid or fat graft rhinofiller injections can be expected in post-rhinoplasty
patients who are suffering from nasal tip complications secondary to their surgery. Additionally, the
long-term reliability of these injections is still under debate, with some suggesting that the duration of
treatment is between 8-12 months, though duration is highly dependent on filler material [66-68] . The prospect
of a less-invasive, lower-risk procedure that can help manage nasal tip complications following rhinoplasty
is certainly intriguing and further trials should be conducted to assess the safety, efficacy, and reliability of
these approaches.

This nasal tip complication analysis suffers from limitations inherent to many reviews focused on
rhinoplasty data. Namely, most of the studies published for aesthetic procedures such as rhinoplasty consist
of retrospective data, case series, or author techniques. Additionally, of note for this paper is an abundance
of technique and review papers focused on alar retraction and nasal tip asymmetry and a relative paucity of
data published on bossae, given the reduced incidence of this complication with more modern methods.

CONCLUSION
Despite these limitations, there exists a wealth of published experience and data among current and past
rhinoplasty surgeons that should prove essential to any aspiring surgeon aiming to prevent and correct
nasal tip deformities. When faced with myriad complication possibilities in rhinoplasty, it is essential for
any rhinoplasty surgeon to have access to a plethora of surgical techniques to address the varied and distinct
nasal tip abnormalities.

DECLARATIONS
Authors’ contributions
Performed the literature review and drafted the manuscript: Randall NR, Peraza LR
Performed the revision and the editing of the manuscript and the design and illustration of figures:
Hamilton III GS

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.