A Cannula-Based Sequential Injection Protocol for Non-surgical Rhinoplasty in East Asian Patients

Non‑surgical rhinoplasty is increasingly popular for nasal augmentation in East Asian patients. However, a standardized, anatomy‑driven protocol for the sequential and layered correction of the nasal tip, dorsum, and glabellar complex-key aesthetic units in the Asian nose-is still lacking.

In this dual‑center retrospective study, 528 East Asian patients (490 females, 38 males; mean age 27.7 years) underwent non‑surgical rhinoplasty between 2020 and 2024. A high‑G' hyaluronic acid filler was injected via cannula in a predefined sequence: first, the nasal tip via fibrous septal deposition; followed by the dorsum and glabellar triangle. Outcomes were assessed using ·FACE‑Q and 3D facial scanning (MVS‑N1) preoperatively and at 9 months.

Three‑dimensional analysis of the 426 patients who received the full three-site protocol showed significant improvements from baseline in nasal length (+ 2.62 mm), tip projection (+ 3.69 mm), nasolabial angle (+ 5.7°), and nasofrontal angle (- 9.4°) (all p < 0.001). FACE‑Q scores significantly improved across all 528 patients in satisfaction (+ 44.4 points), social function (+ 26.2), psychological well‑being (+ 28.1), and reduced distress (- 39.4) (all p < 0.001). No vascular complications occurred; 11 cases had transient erythema that resolved spontaneously or with conservative measures.

The sequential "tip‑dorsum‑glabella" injection protocol, featuring a refined cannula‑based technique for fibrous septal tip augmentation, was associated with a low complication rate and significant short‑term improvements in patient‑reported and anthropometric outcomes in this retrospective analysis, suggesting that it is a clinically feasible approach for non‑surgical rhinoplasty in East Asian patients.

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