title: Medical rhinoplasty with hyaluronic acid and botulinum toxin A: a very simple and quite effective technique.
abstract: OBJECTIVE
  The management of nasal deformities, and in particular those with "plunging" tip, has always been a typical area of interest in surgery. In the author's experience many of these problems can be successfully approached with a new medical technique, which consists of using only hyaluronic acid for the correction of nasal angles and botulinum toxin for patients with hyperactivity of the depressor septi nasi muscle. The present study aims to illustrate this new technique and evaluates safety and results.
  
  
  METHODS
  Ninety-five patients were treated between January 2006 and July 2007. The average age of the patients was 42.7 years. In 45% of the cases, botulinum toxin was employed. In all of the cases, the treatment was conducted with hyaluronic acid (24 mg/mL), the same substance used for face rejuvenation. The amount varied from 0.6 to 1.4 mL.
  
  
  RESULTS
  Results were evaluated using a definitive graduated score calculated by patient's and doctor's satisfaction score (range, 1-10) and by photographs' score at time 0, after 30 days, and after 180 days. It ranged from 8 to 10 (average of 9.1). No significant side effects were reported.
  
  
  CONCLUSIONS
  The medical rhinoplasty for a "plunging" nose is a simple and very effective technique with immediate results. It can be used in those cases where patients are reluctant to undergo surgery, or as primary indication in the correction of minor nose defects. Results are satisfactory and no side effects have been reported so far. Results will last for a long time.
authors.affiliation: Visconti di Modrone Medical Center, Milan, Italy. mail@docredaelli.com
authors.forename: Alessio
authors.initials: A
authors.lastname: Redaelli
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D003357:Cosmetic Techniques; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D009667:Nose Deformities, Acquired / Q000188:drug therapy*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D018570:Risk Assessment; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage*
chemical_list: D009465:Neuromuscular Agents; D055675:Viscosupplements; D006820:Hyaluronic Acid; D019274:Botulinum Toxins, Type A