Nonsurgical Rhinoplasty after Rhinoplasty: A Systematic Review of the Technique, Results, and Complications.

Introduction: Surgical rhinoplasty is a complex procedure with a high revision rate. Nonsurgical rhinoplasty (NSR) could avoid secondary rhinoplasty allowing the correction of postsurgical defects. A systematic review has been performed among adult patients who had previously undergone surgical rhinoplasty and now presenting for NSR with filler, demonstrated most common indications, fillers, and complications in this technique. Materials and Methods: A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) system guidelines. Primary outcomes included indications for NSR in patients with prior rhinoplasty and complication rate. Secondary outcomes included filler material and degree of patient satisfaction. Results: Twenty articles met the inclusion criteria, obtaining 2,048 patients analyzed in the review. Hyaluronic acid was the most used filler, found in 67% of patients. Indications were highly variable, considering deformities of the middle third of the nose the most remarkable. A high degree of satisfaction was found in the analyzed studies and the rate of major complications was low. Discussion and Conclusions: NSR in patients with prior rhinoplasty is a useful option for correcting a range from subtle aesthetic defects to severe nasal deformities. However, this technique is not exempt from complications, since an increased risk of skin necrosis has been observed.