Nonsurgical Injection Rhinoplasty With Calcium Hydroxylapatite in a Carrier Gel (Radiesse): A 4-Year, Retrospective, Clinical Review

The field of facial plastic surgery is experiencing explosive growth in noninvasive and minimally invasive procedures. We describe our experience with a new nonsurgical treatment using calcium hydroxylapatite (CaHA; Radiesse dermal filler [RDF]) injected off label for correction of mild to moderate cosmetic irregularities in patients who do not want to undergo surgical rhinoplasty.

This was a 4-year, retrospective, clinical review of a large sequential series of nonsurgical rhinoplasty patients (385) treated in a private practice setting. The charts of all patients who underwent the nonsurgical rhinoplasty procedure were reviewed. Patients' records of outcomes and adverse events were independently reviewed by a nonblinded observer. Primary outcome measures included recovery time, duration of correction, adverse occurrences, and need for repeat treatment.

Of the 385 patients, follow-up data were available for 295. Of these, 136 patients (46%) had some resorption requiring touch-ups more than 2 months after their initial procedure. Eighty-two patients (28%) had partial resorption requiring touch-ups between 2 and 6 months after their initial procedure; another 54 (18%) patients had touch-ups after 6 months and before 1 year. Prolonged erythema was the only complication, except for 2 patients with partial skin necrosis. Incidence of erythema was higher in patients with previous surgical rhinoplasty history.

We have found that injecting the semipermanent filler RDF can result in relatively safe correction of patients’ aesthetic deficiencies. However, the RDF did not last as long as expected, and the need for touch-ups was more frequent than expected.