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Nonsurgical Rhinoplasty

Nasal Grid Analysis and Nasal Injecting Protocol

Bertossi, Dario, M.D.; Lanaro, Luca, M.D.; Dorelan, Simone, M.D.; Johanssen, Kristen, M.D.; Nocini, Pierfrancesco, M.D.

Plastic and Reconstructive Surgery: February 2019 - Volume 143 - Issue 2 - p 428–439
doi: 10.1097/PRS.0000000000005224
Cosmetic: Original Articles

Background: Nonsurgical rhinoplasty using injectable fillers improved skin quality and texture, cost-effectiveness, and quick recovery. The aim of this study was to provide a valid and customized protocol for injecting the nose with the aid of a nasal grid.

Methods: From January of 2015 to October of 2018, 150 consecutive patients entered the trial. The mean patient age was 36 years (range, 16 to 60 years). The patients were divided into two arms: primary nasal defects (no previous surgery, n = 109) and secondary nasal defects (previous surgery, n = 41). The primary defect group included 43 male patients and 66 female patients, and the secondary nasal defect group included 14 male patients and 27 female patients. Within each arm, patients were stratified into three age group tiers: younger than 30 years, 30 to 45 years, and older than 45 years.

Results: The grid became the reference for quantity and sequence of injection records. The overall complication rate was 1.82 percent, and a visual analogue scale ranging from 1 to 10 was implemented (with 10 being the most accurate correction). Of the patients evaluated, 98.350 percent scored 8 to 10, 0.825 percent scored 6 to 8, and 0.825 percent scored below 6.

Conclusions: Fillers can be either alternatives or complementary to plastic surgery. Nonsurgical rhinoplasty, with its avoidance of general anesthesia, splints, swelling, and bruising, represents a distinct advantage, allowing the patient to return to work as quickly as the same or the next day.


Verona, Italy; and Malvern and Melbourne, Victoria, Australia

From the Division of Dental and Maxillofacial Surgery, “G. B. Rossi Hospital” and Medical University of Verona; Erase Esthetic Services; and Me clinic.

Received for publication February 1, 2018; accepted August 22, 2018.

Disclosure: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this article. Professor Dario Bertossi is Consultant and speaker for Allergan S.p.A.

Dario Bertossi, M.D., Department of Maxillofacial Surgery, University of Verona “G. B. Rossi Hospital”, Piazzale L. A. Scuro 10, 37134 Verona, Italy,, Instagram: @dario bertossi, Facebook: Prof. Dario Bertossi, Website:

©2019American Society of Plastic Surgeons