Abstract Background Nonsurgical rhinoplasty (NSR) utilizing hyaluronic acid (HA) filler injections is increasingly used to address nose shape issues. While refinements have been proposed, the technique lacks standardization. Objectives Our study aimed to evaluate the aesthetic out- come, longevity of results, safety, and patient satisfacti on with the novel Rino-4-Puntos (R4P) NSR techniq ue. Methods This is a retrospective study of consecutive individuals treated with R4P between Janua ry 2021 and July 2023. All participants had one of the four indications: rectification of the dorsu m (21%), triangulation of the tip (32%), projection (25%), and strengthening of the col- umella (22%). Each patient received two hyaluronic acid (HA) fillers: on e with intermediate G prime (G 0 ) at Points 1–3 and another with high G 0 at Point 4, which is further divided into Points 4.1, 4.2, 4.3, and 4.4. The injection points were as follows: P1 (radix, 0.05–0.15 mL, supraperiosteal), P2 (supratip, 0.025 mL, suprachondrial), P3 (tip, 0.15 mL, deep fat), P4 (columella, 0.30 mL, supraperiosteal [4.1], or deep fat [4.2, 4.3, and 4.4]). Results Four hundred individuals (n = 284 [71%] females) are included. The mean filler volume used was 0.65 ± 0.17 mL. Injecting small boluses (B 0.05 mL) in the midline at deep planes minimized the risk of adverse effects, as no vascular complications occurred. Ninety- three percent of participants considered the overall out- come at least satisfactory (‘‘good,’’ ‘‘very good,’’ or ‘‘ex- cellent’’). The treatment effect was maintained for a median of 11 months. Conclusions The R4P technique refines NSR by combin- ing enhanced aesthetic outcome, longevity, and safety. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
agosto 13, 2025
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