Background and Objectives
Although there are multiple guidelines on nasal dorsum augmentation with filler injections, complications are still common. Via a survey, we aimed to obtain an overview of current methods of augmentation rhinoplasty with filler injections and current problems associated therewith in order to suggest proper guidelines for administering injections along the nose.
Materials and Methods
The study analyzed voluntary responses to a questionnaire administered to Korean Medical Association Members who attended the Annual Congress of the Korean Association for Laser, Dermatology, and Trichology on May 19, 2019 in Seoul. The survey consisted of 11 questions concerning the use of filler injections in augmentation rhinoplasty and was conducted as an online survey accessed via the attendees smartphones during the conference.
Results
A total of 306 Korean doctors responded to the survey, describing their own methods for augmentation rhinoplasty with soft tissue filler injections. Among them, 162 tended to use only cannula injections; 107 doctors tended to use only needles. Also, 216 doctors stated that they administered injections at the supraperiosteal layer, with 70 injecting to subdermal layers concomitantly. Surprisingly, 57 doctors reported that they administered injections at the subcutaneous layer. Overall, 354 instances of complications with injections along the nose were reported, along with 54 cases of serious complications, such as skin necrosis and ocular complications.
Conclusion
Many doctors inject soft tissue filler at the supraperiosteal layer either by needle or cannula. They should be aware, however, that this technique is not 100% safe, despite guidelines suggesting that injecting at the supraperiosteal layer is relatively safe. To reduce vascular complication, subcutaneous injections should be avoided.

Keywords: Hyaluronic acid, Filler, Blindness, Augmentation rhinoplasty, Vascular compromise