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A new measuring index for medical rhinoplasty with HA filler: A review and case-series of Tri-hyal Technology

Context: Rhinoplasty is one of the most common aesthetic procedures performed by plastic surgeons. Over the last decades, medical rhinoplasty, or non-surgical rhinoplasty have become a common complementary or alternative of aesthetic surgery especially in Asian population. Hyaluronic acid fillers have become the mainstay treatment for medical rhinoplasty. The major advantages of HA are its malleability, the low potential for immunogenicity and the possible reversibility.

Objective: The aim of this trial was to assess the effect of dermal filler in the reduction of nose tortuosity. In addition, this didactic article also aimed to share tips, tricks and guidelines based on a large experience acquired during almost 15 years of medical rhinoplasty.

Methods: Medical records of 982 patients who had the non-surgical approach for aesthetic disorders of the nasal pyramid at the investigator’s clinic (Nice, France) between 2006 and 2019 were examined retrospectively. Among them, 50 cases treated with the Art filler Universal from FILLMED Laboratories, France were randomly selected. The ratio between the length of the curve and the length of the line linking the two end points is defined as the “tortuosity” or “Braccini Index”. The measuring technique (Newtone® Technologies) was performed on photos.

Results: 86% (n=43) of the subjects demonstrated a significant decrease of the “Braccini Index” from 1.007 ± 0.004 at T0 to 1.003 ± 0.002 at T1 (p<0.05). This statistically significant decrease of the Braccini Index reflects a decrease of the nose bridge.

Conclusion: MR represents an interesting first line treatment in patients that are not willing to have surgery, who have contra-indications for the surgery or for patients who do not seek permanent and radical solution. The selection of dermal filler with the relevant rheological properties is a key factor in achieving a natural-looking long-lasting desired aesthetic outcome. ART FILLER® Universal (Laboratoires FILLMED, France) showed a great safety and a significant efficacy to decrease the tortuosity of the nose bridge.


Frederic Braccini1*, Sarah Gougeon2 and Solène Trevisan2

Abstract | Full-Text | PDF

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