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Objectives: What characteristics make the nose attractive and appealing • The Golden Ratio is 1:1.618. For instance, if the width of a nose is 1, the length of the perfect nose will be 1.618. • An ideal nose should be one-third of the overall face height. • The distance between the nasal ala should be the same as the medial intercanthal distance. Complicationsreported OBJECTIVES Advantages of non-surgical rhinoplasty: • The treatment takes less than one hour. • No downtime is necessary. • Results are immediate. • Reversible effects. • No incisions or scarring. • Safer and convenient than surgical option Introduction: Technical considerations… • Nasal augmentation is the primary cause of nasal tissue necrosis and the second cause of visual loss after the glabella region. • The communication between the external and internal carotid vascular network increases the danger of embolization in a retrograde flow towards the central retinal artery behind the eye. • Vessel constriction or occlusion can occur when the blood vessels have too much pressure or occlusion within the artery resulting in alar or tip necrosis, ocular ischemia or blindness. • The sides of the nose is a no-go zone for a full finger breadth Materials / method: Needle or cannula??? Theoretically speaking, using a small blunt cannula (e.g., 27-gauge) to perform non-surgical rhinoplasty may decrease the risk of vascular occlusion. However, reports of tissue ischemia and blindness have been reported even with canula use. • A technical advantage of using the cannula is apparent when injecting large flat areas (e.g., for dorsum augmentation), which can help decrease local tissue trauma and increase efficiency by minimizing the number of injection points. • A needle injection technique using a small caliber needle (27/30-gauge) ensures precision Results: 5 key points to treat for the perfect nose … • Radix - to improve the depressed nasal bridge • Dorsum of the nose - to create a smooth, sharp and uniform nasal dorsum • Columela - to improve the columellar show and improve the nasolabial angle • Anterior nasal spine - to elevate the nasal tip • Pyriform fossa - to reduce the width of nostrils Post procedure care… .Avoid vigorous physical activities for 4-5 days •Avoid spa activities such as face down massage, steam, sauna, facials,etc •Avoid pressure over the treated area for a week •Avoid direct sun exposure a week •Avoid dental treatment Conclusion: •Nose reshaping/augmentaion is a challenging indication, given the complications such as skin necrosis and visual loss reported. •However, it is imperative that the physicians have a thorough knowledge of the anatomy of the nose with respect to vasculature to avoid intravascular and extravascular complications. •Non- surgical rhinoplasty treatments can be quite a gratifying experience for both, the patients and the physicians. •Post procedure care and instructions is essential for better outcomes