Stepwise Evaluation of Nasal Breathing After Functional Rhinofiller: A Prospective Peak Nasal Inspiratory Flow-Based...

Nonsurgical rhinoplasty with hyaluronic acid (HA) fillers is widely used for aesthetic nasal correction; however, its potential impact on nasal respiratory function remains underexplored. Structural alterations of the nasal tip and columella may influence the external nasal valve and nasal airflow dynamics.

To prospectively evaluate the functional effects of a two-step HA rhinofiller technique on nasal breathing using objective and subjective assessment tools, and to determine the individual contribution of columellar and nasal tip augmentation.

Nine adult female patients with functional nasal breathing impairment related to reduced tip support underwent a standardized two-step rhinofiller procedure. Nine adult female patients seeking nonsurgical rhinofiller treatment for aesthetic nasal concerns, with concomitant varying degrees of subjective nasal obstruction, underwent a standardized two-step rhinofiller procedure. Sequential HA injections were performed at the columella and nasal tip. Objective nasal airflow was measured using peak nasal inspiratory flow (PNIF) at baseline, after the first injection, and after the second injection. Subjective breathing quality was assessed using a visual analog scale (VAS) at baseline, at 10 days, and at 60 days.

Mean PNIF increased significantly after columellar injection (+17.7%) and showed a further significant improvement following nasal tip augmentation (+5.4%), resulting in an overall PNIF increase of 24.0% compared with baseline. Subjective VAS scores improved significantly at 10 days and remained significantly higher than baseline at 60 days. No complications were observed.

A targeted two-step functional rhinofiller protocol using HA can significantly improve nasal airflow and patient-perceived breathing quality. Columellar augmentation appears to provide the greatest functional benefit, supporting the concept of rhinofiller as a minimally invasive functional intervention in selected patients.