The “R-evolution” technique: a pilot observational study of a stepwise nonsurgical rhinoplasty approach using hyaluronic acid fillers

Nonsurgical rhinoplasty (NSR) using hyaluronic acid (HA) fillers has become an increasingly popular alternative to surgical rhinoplasty for selected nasal deformities. We describe the R-Evolution (Rhinofiller Evolution) technique, a stepwise and personalized HA filler injection protocol designed to reshape the nasal profile while minimizing complications. A retrospective, single-center, pilot observational study was conducted on consecutive patients treated in private practice between 2022 and 2024. Patient satisfaction and adverse events were assessed during follow-up using a four-point Likert scale. A total of 137 patients were included. at 3-moth follow up 126 of 130 patients (96.9%) reported being satisfied or very satisfied with the aesthetic outcome. Adverse events were predominantly mild and self-limiting, and no major vascular complications were observed. The staged R-Evolution approach was associated with high patient satisfaction and predominantly mild adverse events in this cohort. The absence of major vascular complications should not be interpreted as evidence of safety for rare adverse events. Not applicable.