Filler rhinoplasty based on anatomy: The dual plane technique.

Filler rhinoplasty is susceptible to spreading because of the way the nose protrudes away from the face. Often, the well-defined appearance immediately after the procedure is poorly maintained, and the nasion area develops a bulbous appearance. Therefore, I developed a "dual plane technique" to prevent spreading and to maintain the desired shape of the filler rhinoplasty. Dual plane injections were administered in 96 patients. Based on the anatomy of the nose, a highly elastic filler was injected in the deep fat layer and a moderately elastic filler was injected in the superficial fat compartments. The retrograde linear threading technique was used to inject the fillers to prevent mixing with each other. Afterwards, the highly elastic hyaluronic acid filler was injected from the anterior nasal spine into the supracartilaginous layer by a retrograde linear threading technique. All patients were followed up for at least 3 months, during which time there were no major complications and aesthetic satisfaction was high. The dual plane technique is an injection technique based on the anatomical base. Different types of filler can be used according to the plane and filler rheology to obtain an aesthetically pleasing result.