Redefining alar retraction: can hyaluronic acid replace the scalpel?
Reviewed by Shivanchan Rajmohan

Alar retraction is a common challenging nasal deformity and requires precise structural correction to achieve both functional and aesthetic harmony. Traditionally correction of alar retraction has relied on open rhinoplasty with various techniques including cartilage grafting, suturing techniques and advancement flaps. This single-centre retrospective study based in China reviewed outcomes of 44 adult patients with mild-moderate alar retraction that received hyaluronic acid injections over a two-year period. Mean follow-up was 11 months and mean age of subjects was 32.9 years. Standardised photographic analysis and self-assessment using the visual analogue scale (VAS) was utilised to evaluate patient satisfaction with the shape of alar rim post-filler injection. Finite element modelling was incorporated to simulate tissue deformation and stress distribution after filler injection. The study concluded statistically significant improvement in mean VAS score post hyaluronic acid injection, with 86.3% reporting complete satisfaction. This result extends across all three alar retraction subtypes (medial, central and lateral). Good safety was demonstrated, with only minor bruising in a few patients and no cases of skin necrosis or vascular complications. Biomechanical simulations demonstrated linear dose-dependent relationship between volume of injected hyaluronic acid filler and tissue deformation; this suggests that predictable correction can be achieved with volumetric planning. Mechanical stretching of alar rim was shown to produce minimal deformation but helped with tissue compliance and injection safety when used adjunctively. These results should be interpreted in light of the small sample size, uncertain long-term durability data and the possibility that finite element models may not fully capture the complexity of nasal tissue biomechanics. Could a combination of precise filler technology and biomechanical analysis help correct selected nasal deformities predictably without surgery?

Hyaluronic acid injections for alar retraction: a retrospective study on clinical effects and biomechanics.
Jin M, Ma, Y, Lu L, et al.
J PLAST RECONSTR AESTHET SURG
2026 [ePub ahead of print].