Nonsurgical Elementary Rhinoplasty: A Volumetric Standardized Hyaluronic Acid Filling Technique in Five Steps
- The NOSER (Nonsurgical Elementary Rhinoplasty) technique is a standardized, stepwise approach for nasal reshaping using hyaluronic acid (HA) fillers.
- It involves five precise steps targeting different nasal subunits: anterior nasal spine, columella, tip, radix, and supratip.
- Two cannula entry points (glabella and columella) are used for delivering HA in deep nasal planes (supraperichondrial and supraperiosteal).
- Cannulas (22/23-gauge, 50 mm) are preferred over needles for safety and anatomical precision.
- The technique aims for minimal invasiveness with natural outcomes—projected tip, aligned dorsum, and improved columellolabial angle.
- It uses high G-prime HA and adapts volume based on individual nasal anatomy.
- Aesthetic improvements can be achieved without necessarily using all five steps.
- Reassessment and touch-up are advised after 30 days.
- Designed for injectors with anatomical proficiency to safely and effectively enhance nasal contour.
The Rise of Nonsurgical Nose Contouring: Exploring the Five-Step NOSER Hyaluronic Acid Filler Technique
In the rapidly evolving field of aesthetic medicine, nonsurgical rhinoplasty has emerged as one of the most sought-after procedures. For patients hesitant about the risks, downtime, or cost of surgery, minimally invasive techniques offer a promising alternative. The recent article “Nonsurgical Elementary Rhinoplasty: A Volumetric Standardized Hyaluronic Acid Filling Technique in Five Steps” by Oliveira et al., published in the Indian Journal of Plastic Surgery (2025), proposes a game-changing approach. Known as the NOSER technique, this protocol presents a methodical, reproducible system for enhancing nasal aesthetics using hyaluronic acid (HA) fillers.
The human nose, often regarded as the central aesthetic landmark of the face, plays a critical role in facial symmetry, balance, and expression. Minor imperfections—like a droopy tip, slight hump, or under-projected radix—can disproportionately affect appearance. Traditionally, correction required surgical rhinoplasty, but in recent years, the paradigm has shifted toward office-based procedures. The NOSER technique fills a crucial gap in the practice: standardizing filler rhinoplasty for safety and consistent, natural-looking results.
The method is refreshingly simple yet grounded in anatomical precision. It uses just two insertion points—one at the glabella and one at the columella—and a cannula to deliver high G-prime HA filler across five specific nasal zones. Each of these zones corresponds to a particular aesthetic component: the anterior nasal spine (Step 1), the columella (Step 2), the nasal tip (Step 3), the radix (Step 4), and the supratip (Step 5). All injections are performed in the deep plane to minimize vascular complications and enhance filler integration with native structures.
What distinguishes this approach is its blend of artistry and anatomical rigor. For instance, the first step—injecting the anterior nasal spine—supports the columella and opens the nasolabial angle, lifting the tip. Depending on the nasal spine’s projection, volume can range from 0.0 to 0.2 mL. The second step enhances columellar support by retro-injecting HA into the interperichondrial layer, respecting natural anatomical variance in columellar position (normal, retracted, or exposed).
Tip definition (Step 3) is a particularly nuanced element of the technique. Depending on the tip shape—tapered or bifid—fillers are placed over the domes of the lower lateral cartilages without breaching them, ensuring precise definition without risking vascular compromise. Similarly, radix correction (Step 4) is executed through a supraperiosteal injection, straightening the nasal dorsum and improving the frontonasal angle. If performed skillfully, even minor humps under 2 cm can be camouflaged. Finally, the supratip (Step 5) is treated to create a subtle break or flattening, depending on patient preference.
A notable strength of the NOSER protocol is its adaptability. Not all five steps are necessary for every patient. In individuals with a well-projected columella, Steps 1 and 2 can be skipped. Likewise, if the radix is already harmonized, Step 4 may be omitted. This modularity is key to ensuring natural outcomes without overfilling or distorting the nasal contour.
Another compelling aspect is safety. The article reinforces the use of cannulas rather than needles to navigate the complex vascular anatomy of the nose. The lateral nasal arteries run superficially and laterally, making central deep-plane injection safer. Using a 22- or 23-gauge cannula also reduces the risk of intravascular injection—a complication that, while rare, can result in catastrophic outcomes like necrosis or blindness.
Patient selection and preparation are also emphasized. Ideal candidates include those with thin skin, mild dorsal humps (<2 cm), droopy tips, and narrow nasal bridges. Before injection, topographical landmarks are mapped, including the nasion, radix, nasal tip, and aesthetic dorsal lines. This ensures precise delivery and symmetry. Moreover, the aesthetic result is reassessed after 30 days, allowing for touch-up if required.
The authors draw attention to subtle pitfalls. Injecting at the wrong angle in Step 1, for example, can lead to undesirable filler migration to the septum or frenulum. Similarly, excessive correction of the supratip can weigh down the tip or produce an unnatural “Greek nose.” These insights reveal the importance of anatomical training and a conservative, stepwise mindset.
From a patient-centric viewpoint, this technique offers enormous appeal. The procedure is fast (often under 30 minutes), requires no general anesthesia, and has minimal downtime. Most patients return to daily activities the same day. Moreover, HA fillers are reversible, offering an added layer of psychological comfort to first-time patients.
Still, this technique is not a panacea. It is best suited for patients seeking subtle refinement, not those with major structural deformities or functional nasal issues. As with all aesthetic procedures, managing patient expectations is crucial.
The NOSER technique also holds promise as a training tool. By clearly demarcating steps, volumes, and anatomical guidelines, it offers injectors—especially dermatologists and facial plastic surgeons—a reproducible framework to enhance safety and aesthetic outcomes. The use of multimedia resources like cadaver demonstrations and procedural videos embedded in the article further strengthens its educational value.
In summary, the NOSER technique represents a refined, reproducible, and safer method of performing nonsurgical rhinoplasty. It brings structure and clarity to a previously inconsistent field, offering practitioners and patients alike a roadmap to achieve natural, elegant nasal aesthetics without going under the knife. As nonsurgical procedures continue to rise in popularity, techniques like NOSER are poised to become gold standards in modern aesthetic practice.
Reference
Oliveira LL, Braz A, Palermo E, Issa MCA. Nonsurgical Elementary Rhinoplasty: A Volumetric Standardized Hyaluronic Acid Filling Technique in Five Steps. Indian J Plast Surg. 2025;58:139–145. doi:10.1055/s-0045-1802317
FAQs
- What is nonsurgical elementary rhinoplasty with hyaluronic acid fillers?
It is a minimally invasive technique using dermal fillers to reshape and enhance the nose without surgery, downtime, or stitches. - Can hyaluronic acid nose fillers fix a droopy nasal tip?
Yes, the NOSER technique uses specific steps to project and lift the nasal tip, improving its alignment and angle. - Are non-surgical nose fillers safe for straightening a small nasal hump?
Absolutely. The NOSER technique can camouflage mild to moderate humps by filling the areas around them for a straighter profile. - Is the NOSER filler rhinoplasty reversible if I don’t like the result?
Yes, since it uses hyaluronic acid, the filler can be dissolved with an enzyme called hyaluronidase. - How long does a nonsurgical nose job with HA fillers last?
Typically, results last between 9 to 18 months, depending on the product and individual metabolism. - What is the recovery time after nonsurgical rhinoplasty using the NOSER technique?
Most patients resume normal activities the same day, with minor swelling or bruising lasting a few days. - Can men get nonsurgical rhinoplasty using the NOSER technique?
Yes, it is suitable for both men and women with mild nasal irregularities. - How much filler is used in the non-surgical rhinoplasty technique?
A total of 0.3 to 0.5 mL is generally sufficient, tailored to the individual’s anatomy and desired correction. - Is it painful to get hyaluronic acid fillers in the nose?
A topical anesthetic is applied before the procedure to minimize discomfort, making it very tolerable for most patients. - Will hyaluronic acid fillers make my nose look natural?
When performed using the NOSER method, fillers can create very natural and harmonious results, enhancing your features without exaggeration.
Keywords
hyaluronic acid nose filler, nonsurgical rhinoplasty, nose tip projection, supratip correction, safe nose filler technique, HA rhinoplasty steps, NOSER technique, nasal contouring with filler
Nonsurgical Elementary Rhinoplasty with Hyaluronic Acid: The NOSER Technique Explained
nonsurgical rhinoplasty, hyaluronic acid, minimally invasive techniques, nasal aesthetics, filler rhinoplasty
non-surgical nose job without surgery, natural nose contouring using dermal fillers, HA filler for nasal tip lift, how to fix nose hump without surgery
Explore the NOSER technique—an advanced, five-step method using hyaluronic acid for nonsurgical rhinoplasty with natural, safe, and aesthetic outcomes. Ideal for men and women.