Non-surgical Rhinoplasty with Hyaluronic acid Fillers: Predictable Results Using Software for the Evaluation of Nasal Angles



There is a relative lack of evidence on optimal products and techniques for nose treatment with hyaluronic acid (HA) fillers. This study assessed the efficacy and safety of nasal reshaping with Vycross HA fillers, using a free software (Face Master) to measure facial parameters.


This was a prospective, open-label, single-center study of consecutive adult patients treated in the nose (bony and cartilaginous dorsum and/or columella) with VYC-20 or VYC-17.5. A maximum of 1 mL of filler was used. All patients (except one) had at least 12 months of follow-up.


Sixty-two patients were enrolled (57 females; 5 males) with a mean age of 29.0 ± 9.2 years. A mean of 0.55 ± 0.22 mL of filler (range 0.2–1.0 mL) was injected during initial treatment; 12 patients required touch-up with 0.15 ± 0.08 mL of filler (range 0.1–0.3 mL). Using Face Master, mean nasofrontal angle increased from 143.6 ± 6.3° pre-treatment to 147.3 ± 6.7° post-treatment (mean change 3.7 ± 2.8°), and mean nasolabial angle increased from 85.3 ± 6.1° to 88.5 ± 6.1° (mean change 3.2 ± 2.6°). Mean patient satisfaction (0–10 scale) increased from 2.4 ± 1.7 pre-treatment to 9.4 ± 0.8 post-treatment (mean improvement 7.1 ± 2.1). Complications were minor and transient: pain, n = 3 (4.8%); edema, n = 3 (4.8%); hematoma, n = 2 (3.2%).


Non-surgical nasal reshaping with VYC-20 or VYC-17.5 appeared to be efficacious and safe; Face Master objectively demonstrated meaningful changes in key nasal angles.

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

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3


  1. 1.

    Hatch CD, Wehby GL, Nidey NL, Moreno Uribe LM (2017) Effects of objective 3-dimensional measures of facial shape and symmetry on perceptions of facial attractiveness. J Oral Maxillofac Surg 75:1958–1970

    Article  Google Scholar 

  2. 2.

    Przylipiak M, Przylipiak J, Terlikowski R et al (2018) Impact of face proportions on face attractiveness. J Cosmet Dermatol 17:954–959

    Article  Google Scholar 

  3. 3.

    American Society of Plastic Surgeons. 2018 National Plastic Surgery Statistics. Available at: Accessed 11 Sept 2019

  4. 4.

    Few J, Cox SE, Paradkar-Mitragotri D, Murphy DK (2015) A multicenter, single-blind randomized, controlled study of a volumizing hyaluronic acid filler for midface volume deficit: Patient-reported outcomes at 2 years. Aesthet Surg J 35:589–599

    Article  Google Scholar 

  5. 5.

    Goodman GJ, Swift A, Remington BK (2015) Current concepts in the use of Voluma, Volift, and Volbella. Plast Reconstr Surg 136:139S–148S

    CAS  Article  Google Scholar 

  6. 6.

    Philipp-Dormston WG, Eccleston D, De Boulle K et al (2014) A prospective, observational study of the volumizing effect of open-label aesthetic use of Juvéderm® VOLUMA® with Lidocaine in mid-face area. J Cosmet Laser Ther 16:171–179

    Article  Google Scholar 

  7. 7.

    Philipp-Dormston WG, Hilton S, Nathan M (2014) A prospective, open-label, multicenter, observational, postmarket study of the use of a 15 mg/mL hyaluronic acid dermal filler in the lips. J Cosmet Dermatol 13:125–134

    Article  Google Scholar 

  8. 8.

    Humphrey S, Carruthers J, Carruthers A (2015) Clinical experience with 11,460 ml of a 20-mg/mL, smooth, highly cohesive, viscous hyaluronic acid filler. Dermatol Surg 41:1060–1067

    CAS  Article  Google Scholar 

  9. 9.

    Raspaldo H, Chantrey J, Belhaouari L et al (2015) Lip and perioral enhancement: a 12-month prospective, randomized, controlled study. J Drugs Dermatol 14:1444–1452

    PubMed  Google Scholar 

  10. 10.

    Calvisi L, Gilbert E, Tonini D (2017) Rejuvenation of the perioral and lip regions with two new dermal fillers: the Italian experience with Vycross™ technology. J Cosmet Laser Ther 19:54–58

    Article  Google Scholar 

  11. 11.

    Geronemus RG, Bank DE, Hardas B et al (2017) Safety and effectiveness of VYC-15L, a hyaluronic acid filler for lip and perioral enhancement: one-year results from a randomized, controlled study. Dermatol Surg 43:396–404

    CAS  Article  Google Scholar 

  12. 12.

    Li D, Wang X, Wu Y et al (2017) A randomized, controlled, multicenter study of Juvéderm Voluma for enhancement of malar volume in Chinese subjects. Plast Reconstr Surg 139:1250e–1259e

    CAS  Article  Google Scholar 

  13. 13.

    Monheit G, Beer K, Hardas B et al (2018) Safety and effectiveness of the hyaluronic acid dermal filler VYC-17.5L for nasolabial folds: results of a randomized, controlled study. Dermatol Surg 44:670–678

    CAS  Article  Google Scholar 

  14. 14.

    Liew S, Scamp T, de Maio M et al (2016) Efficacy and safety of a hyaluronic acid filler to correct aesthetically detracting or deficient features of the Asian nose: a prospective, open-label, long-term study. Aesthet Surg J 36:760–772

    Article  Google Scholar 

  15. 15.

    Rauso R, Colella G, Zerbinati N, Salti G (2017) Safety and early satisfaction assessment of patients seeking nonsurgical rhinoplasty with filler. J Cutan Aesthet Surg 10:207–214

    Article  Google Scholar 

  16. 16.

    Bertossi D, Lanaro L, Dorelan S et al (2019) Nonsurgical rhinoplasty: nasal grid analysis and nasal injecting protocol. Plast Reconstr Surg 143:428–439

    CAS  Article  Google Scholar 

  17. 17.

    Ozkul T, Ozkul MH, Akhtar R et al (2009) A software tool for measurement of facial parameters. Open Chem Biomed Methods J 2:69–74

    Article  Google Scholar 

  18. 18.

    Armijo BS, Brown M, Guyuron B (2012) Defining the ideal nasolabial angle. Plast Reconstr Surg 129:759–764

    CAS  Article  Google Scholar 

  19. 19.

    Prantl L, Brandl D, Ceballos P (2017) A proposal for updated standards of photographic documentation in aesthetic medicine. Plast Reconstr Surg Glob Open 5:e1389

    Article  Google Scholar 

  20. 20.

    Bertossi D, Cavallini M, Cirillo P et al (2018) Italian consensus report on the aesthetic use of onabotulinum toxin A. J Cosmet Dermatol 17:719–730

    Article  Google Scholar 

  21. 21.

    Mohamed WS, El-Shazly MM, El-Sonbaty MAH, Eloteify MM (2013) Objective versus subjective assessment for rhinoplasty. Egypt J Plast Reconstr Surg 37:73–79

    Google Scholar 

  22. 22.

    de Maio M, DeBoulle K, Braz A et al (2017) Facial assessment and injection guide for botulinum toxin and injectable hyaluronic acid fillers: focus on the midface. Plast Reconstr Surg 140:540e–550e

    Article  Google Scholar 

  23. 23.

    McCleve DE, Goldstein JC (1995) Blindness secondary to injections in the nose, mouth, and face: cause and prevention. Ear Nose Throat J 74:182–188

    CAS  Article  Google Scholar 

  24. 24.

    Rayess HM, Svider PF, Hanba C et al (2018) A cross-sectional analysis of adverse events and litigation for injectable fillers. JAMA Facial Plast Surg 20:207–214

    Article  Google Scholar 

  25. 25.

    Heydenrych I, Kapoor KM, De Boulle K et al (2018) A 10-point plan for avoiding hyaluronic acid dermal filler-related complications during facial aesthetic procedures and algorithms for management. Clin Cosmet Investig Dermatol 11:603–611

    CAS  Article  Google Scholar 

  26. 26.

    Jasin ME (2013) Nonsurgical rhinoplasty using dermal fillers. Facial Plast Surg Clin N Am 21:241–252

    Article  Google Scholar 

  27. 27.

    Johnson ON 3rd, Kontis TC (2016) Nonsurgical rhinoplasty. Facial Plast Surg 32:500–506

    CAS  Article  Google Scholar 

  28. 28.

    Wang LL, Friedman O (2017) Update on injectables in the nose. Curr Opin Otolaryngol Head Neck Surg 25:307–313

    Article  Google Scholar 

Download references


The authors thank Dr. Timothy Ryder from Biological Communications Limited (London, UK) for assistance in editing and submitting the final draft, funded by Allergan at the request of the investigator. Neither honoraria nor payments were made for authorship.

Author information



Corresponding author

Correspondence to Adriano Santorelli.

Ethics declarations

Conflict of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and publication of this article.

Ethical Approval

The study was conducted in accordance with the Declaration of Helsinki.

Informed Consent

All subjects provided written informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Santorelli, A., Marlino, S. Non-surgical Rhinoplasty with Hyaluronic acid Fillers: Predictable Results Using Software for the Evaluation of Nasal Angles. Aesth Plast Surg 44, 919–926 (2020).

Download citation


  • Face Master
  • Hyaluronic acid
  • Nasal reshaping
  • VYC-20
  • Vycross