Resumo

Objectives: To assess the clinical outcomes, safety, and functional benefits of hyaluronic acid (HA) filler injections administered in the supraperichondrial plane as a non-surgical treatment for alar collapse. This study aims to determine whether this minimally invasive approach can provide effective structural support and aesthetic improvement, particularly in patients with a history of rhinoplasty, where traditional surgical options may be limited or carry higher risk. Introduction: Alar collapse is a clinical condition caused by congenital, primary, or iatrogenic factors, often resulting in both inspiratory dysfunction and aesthetic deformities. It is one of the most common reasons for revision rhinoplasty. Despite the widespread use of autologous cartilage grafting, surgical correction—especially in secondary cases—remains challenging . As a result, there is growing interest in non-surgical alternatives that can restore structural support and improve aesthetics with lower risk and recovery time. Hya Materials / method: A total of 96 patients, the majority of whom had previously undergone rhinoplasty, were treated with HA filler injections. The injection volume ranged from 0.05 to 0.1 cc per side, using a 30G needle. The product was precisely delivered into the supraperichondrial plane, located beneath the subcutaneous fat and above the lateral alar cartilage. To confirm the safety of this anatomical plane, cadaveric dissections were performed, demonstrating that this area is devoid of major vascular structures, thereby minimizing the risk of vascular compromise. Results: Photographic documentation showed a notable improvement in nasal contour and alar support following the procedure. Functionally, patients experienced enhanced nasal airflow and reduction in dynamic collapse during inspiration. Subjective patient feedback reflected high satisfaction with both aesthetic and functional outcomes. The procedure was well-tolerated, with no major complications reported. The reversibility of HA fillers added a layer of safety and adaptability in patient care. Conclusion: Supraperichondrial HA filler injections offer a safe, effective, and minimally invasive solution for managing alar collapse, especially in patients with prior rhinoplasty. This technique provides immediate structural reinforcement and aesthetic enhancement, with a favorable risk profile and outpatient applicability. If validated in larger studies, this approach could reshape current treatment protocols, bridging the gap between surgical and non-surgical nasal correction methods.