Immediate improvement of alar drooping and nostril shape by hyaluronic acid filler injection into the perialar regions: a case study

Abstract

After the augmentation rhinoplasty, the unnatural nasal contour is commonly happened in the patient who had premaxillary and perialar depression. In this study, the authors would like to introduce an interesting outcome that the unnatural nasal contour such as alar drooping and a spindle-shaped nostril was significantly improved by hyaluronic acid filler injection into the perialar and nasolabial fold regions in the case of perialar depression with premaxillary protrusion. The hyaluronic acid filler was injected into the perialar region first and then injected into nasolabial folds region using a 22-gauged blunt cannula through the entry site located at the central perialar region. Approximately 70% of the total filler volume (about 9.5 ml) was placed on the nasal process of the maxillary bone (attached) or in the deep fat layer (injected), while 20%-30% of the filler volume was injected into the superficial fat layer. No fat placed under the dermal layer at the perialar region, and 10% volume was injected under the dermis at the central crease of the folds. The patient’s satisfaction was a great. The improved droopy alar, and the change of the nostril from the spindle shaped to the triangular shaped were observed. The morphological changes were corresponded to the change of measurements as follow that the angle of nostril axis and the columellar height were decreased, on the other hand, interaxial angle and the alar base width were increased. From the above result, the filler injection can be used as a reliable and non-invasive technique for the correction of alar drooping with a spindle-shaped nostril by augmentation of the perialar depression.

Keywords

• alar drooping
• hyaluronic acid filler
• nostril shape
• perialar region