Nose Tip Elongation and Elevation: A Novel Filler Injection Technique

Background Filler injection for nose tip improvement remains a difficult subject due to efficacy and safety issues. Objectives To better the techniques and safety for nose tip improvement with a filler. Methods Patients seeking nose tip improvement were recruited regardless of their pre-treatment conditions. A hyaluronic acid filler is injected through the skin behind the nose tip into the potential septal space. To achieve tip elevation, the filler is retro injected from the anterior nasal spine, stopping at the mid-level of medial crura. To elongate the nose, the filler is deposited just in front of the caudal septal cartilage. The tip extends in the sagittal plane, causing the nose tip to move either caudally (tip elongation) or anteriorly (tip elevation), or both, as directed by the surgeon. Results Depending on the patients, the nose could be elongated by 2 to 6mm, and the tip could be elevated by 2 to 8 mm. Additionally, stronger columellar support, finer tip structures, and improved nasolabial angle are observed. Interestingly, the upper lip appears shorter. The nostril shapes and the alar widths are also improved. A total of 1288 cases are reported. Only two patients expressed dissatisfaction. Conclusions This technique is easy and safe to perform and, the results are natural and comparable to those from rhinoplasty surgeries. Further, this report of filler nose lengthening may be the first large series in the world. Finally, this technique works well in all populations.