Background: Nonsurgical Rhinoplasty (NSR) using soft-cohesive crosslinked hyaluronic acid (HA) was performed to reshape the nose appearance. Knowledge of the nasal anatomy mostly the blood supply, adequate placement of the HA, and potential complications became NSRHA safe and effective. Method: Twenty females underwent NSR to enhance their nose appearance. Injection points were distributed along the nose midline from columella to the bridge. HA was injected supraperichondrial and supraperiosteally on columella, into the interdomal fat pad on tip, and into the deep fatty layer on dorsum and bridge. Bolus injection was made in the tip and columella. A single row retrograde flow injection was made in the dorsum-bridge line. ROE questionnaire assessed quantitatively the patient's self-consciousness of the nose appearance and the scores correlated with the images of the nose before- and after-NSR. Results: NSR-HA was performed in a single session. Volume average per patient/treatment was 0.73 ml and per point/treatment was 0.17 ml. Comparing images of the nose before- and after-NSR showed a significant improvement of the nose appearance. Patient satisfaction was quantitatively demonstrated by the ROE questionnaire scores of 31.04% before-NSR against 73.33% and 70.00% at months one and twelve, respectively, after-NSR. The difference of 3.33%, greater at month one than month twelve, indicated no significant changes in the nose appearance for twelve months. Conclusions: Positive evaluation of NSR-HA was evidenced comparing the nose images before, and at months one and twelve after HA injection validated by the patient self-consciousness of the nose appearance measured by the ROE questionnaire.
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