Advancing the Era of Liquid Rhinoplasty: A Methodological Approach to Injection Protocols

Liquid rhinoplasty, a non-surgical procedure using hyaluronic acid (HA) to reshape and refine the nose, has gained in popularity as an alternative to traditional surgical rhinoplasty although its results are not definitive. However, the lack of standardized injection protocols has raised concerns about treatment consistency and patient safety. In this article, the authors propose a systematic protocol for the most common indications of liquid rhinoplasty. By adopting a standardized methodology, healthcare professionals can enhance patient safety, improve treatment consistency, and optimize patient satisfaction. The protocol includes standardized injection sites categorized as dorsal, paramedian, tip and endonasal injections. Specific injection areas are recommended for different nasal shapes such as droopy noses, dorsal humps, nasal saddle deformity, inverted V deformity, tip shape abnormalities, twisted noses, revision cases with dorsal irregularities, and internal nasal valve dysfunction. While variations in filler dosages may be necessary based on individual patient needs, a conservative approach is recommended to maintain natural-looking results and reduce the risk of complications. The increase in non-surgical techniques for nasal refinement offers patients more options, and systematized injection protocols based on different nasal types provide a structured framework for liquid rhinoplasty. 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 .