Filler rhinoplasty based on anatomy: The dual plane technique

Gyu Sik Jung

doi:10.1016/j.jpra.2019.04.002

Abstract

Filler rhinoplasty is susceptible to spreading because of the way the nose protrudes away from the face. Often, the well-defined appearance immediately after the procedure is poorly maintained, and the nasion area develops a bulbous appearance. Therefore, I developed a “dual plane technique” to prevent spreading and to maintain the desired shape of the filler rhinoplasty. Dual plane injections were administered in 96 patients. Based on the anatomy of the nose, a highly elastic filler was injected in the deep fat layer and a moderately elastic filler was injected in the superficial fat compartments. The retrograde linear threading technique was used to inject the fillers to prevent mixing with each other. Afterwards, the highly elastic hyaluronic acid filler was injected from the anterior nasal spine into the supracartilaginous layer by a retrograde linear threading technique. All patients were followed up for at least 3 months, during which time there were no major complications and aesthetic satisfaction was high. The dual plane technique is an injection technique based on the anatomical base. Different types of filler can be used according to the plane and filler rheology to obtain an aesthetically pleasing result.

Highlights

Rhinoplasty is one of the most common aesthetic procedures performed by plastic surgeons worldwide
The dual plane technique is an injection technique based on the anatomical base
Certain individuals may develop swelling due to inflammation after the procedure, while in some cases, the filler, being a gel, may spread into the nasal bridge and alae during the process of absorption

Summary

Introduction

Rhinoplasty is one of the most common aesthetic procedures performed by plastic surgeons worldwide. A non-surgical rhinoplasty has become the preferred option for most patients and physicians.[1] The most common non-surgical method for volume correction is fillers.[2] Filling properties allow the physician to obtain optimal results with a minimal downtime and good longevity.[3] In the past, fillers were used for surface treatments with a dermatologic approach and temporary results. Fillers are no longer used to address wrinkles but mostly to restore volumes.[2] fillers are injected into the deep planes and not the skin; the injection strategy is based on surgical concepts and is aimed at maintaining the results.[4] The soft tissue of the nose consists of five layers: the skin, superficial fatty layer, fibromuscular layer, deep fatty layer and the periosteum/perichondrium.[1]

Methods

Results

Conclusion