Delayed Iatrogenic Nasal Hump Induced by Hyaluronic Acid Filler: A Rare Long-Term Complication

Rhinoplasty is frequently performed in Asian populations, with nonsurgical rhinoplasty using hyaluronic acid (HA) fillers becoming an increasingly popular alternative for patients seeking subtle corrections, those with contraindications to surgery, or individuals preferring temporary, less-invasive solutions. HA fillers are often combined with other minimally invasive procedures, such as barbed thread insertion, to enhance aesthetic outcomes and overcome individual limitations. Although these procedures are generally considered safe, most complications are reported within a short treatment period, allowing for timely management. Here, the authors present a rare case of a patient who underwent nonsurgical rhinoplasty using HA fillers and barbed threads 4 years prior and later sought revision surgery due to a nasal dorsal hump. Medical management failed to improve the condition, prompting revision surgery. Intraoperatively, the hump was found to be a firm, fixed capsule of granulation tissue formed around the previously injected HA filler, rather than a true bony prominence. This case highlights the potential for delayed complications after nonsurgical rhinoplasty and underscores the importance of considering long-term tissue responses, particularly when multiple techniques are combined.