Hyaluronic acid injections for alar retraction: a retrospective study on clinical effects and biomechanics.

Abstract

Nasal alar retraction poses a considerable clinical challenge. Conventional correction often relies on open rhinoplasty with cartilage grafting, which carries inherent surgical risks. For mild to moderate cases, hyaluronic acid (HA) fillers represent a promising and minimally invasive alternative. We aimed to evaluate the clinical outcomes of HA injection for correcting nasal alar retraction by integrating objective photographic measurements, patient-reported outcomes, and finite element analysis (FEA). A retrospective, single-center study was conducted on patients who received HA injections for alar retraction between June 2023 and July 2025. Outcomes were assessed through pre- and postoperative photographic measurements and a patient self-assessment questionnaire. FEA was employed to simulate rim displacement and von Mises stress distribution. All 44 patients who completed the study (mean follow-up: 11.2 months) showed significant morphological improvement in the alar rim (P < 0.001), consistent across lateral, central, and medial subtypes. Patient satisfaction scores increased markedly from a mean of 3.18 to 8.16 (P < 0.001). FEA demonstrated a linear, dose-dependent relationship between the clinical effect and deformation/stress. Hyaluronic acid injection provides predictable esthetic improvement and high patient satisfaction for mild to moderate alar retraction, with a linear, dose-dependent effect facilitating precise correction.