Two approaches are available depending on your needs and anatomy: 1. Medical Rhinoplasty with Hyaluronic Acid (non-surgical) — 2. Surgical Rhinoplasty (primary & revision).

Medical Rhinoplasty with Hyaluronic Acid (Non-Surgical)

Nose Harmony Without Surgery, by Dr Afshin Yousefpour

Maxillofacial expertise applied to millimeter precision and vascular safety.

Medical rhinoplasty is a highly technical nose-reshaping technique using hyaluronic acid injections. It suits patients who want to correct targeted shape irregularities, harmonize their nasal proportions, or refine their profile lines — without general anesthesia, without incisions, and without social downtime.

Because the nose contains a complex, terminal vascular network connected to the ophthalmic and facial arteries, this procedure should never be taken lightly. As a Maxillofacial and Facial Plastic Surgeon, Dr Afshin Yousefpour has an intimate knowledge of the deep anatomical planes. This surgical training allows him to inject at precise levels (sub-aponeurotic and supra-periosteal), delivering a natural, elegant result.

Indications and Clinical Possibilities

Medical rhinoplasty works through optical illusion and strategic filling:

  • Softening a bony-cartilaginous hump: By filling the hollow above (the naso-frontal angle) and below the hump, the nasal bridge is visually aligned and straightened.
  • Tip projection and rotation: Supporting the naso-labial angle to lift a subtly drooping or overly flat tip.
  • Correcting asymmetries and depressions: Restoring straight dorsal lines in patients with a lateral hollow or a minor deviation.
  • Post-surgical touch-ups: Fine correction of residual irregularities or small hollows after a previous surgical rhinoplasty, avoiding a return to the operating room.

How the In-Office Treatment Works

  1. Initial consultation & shape analysis: Dynamic photographic analysis of the profile, of the naso-frontal and naso-chin proportions, and a check for contraindications.
  2. Preparation & disinfection: A numbing cream may be applied; the hyaluronic acid gel itself contains lidocaine for complete comfort.
  3. High-precision injections: Drop-by-drop injection of highly cohesive, viscoelastic hyaluronic acid micro-boluses into the deep tissue planes.
  4. Shaping & immediate review: Manual shaping of the contours, checked directly with you using a mirror. The session takes 20 to 30 minutes on average.

Advantages & Limits of the Medical Approach

Strengths of Medical Rhinoplasty Limits / Situations Requiring Surgery
Instant result as soon as the session ends Cannot reduce the overall size of an already large nose
Zero time off work, no splint or cast Does not correct a deviated septum or nasal obstruction
Reversible thanks to hyaluronidase Very thick skin responds less precisely
Lasts 12 to 18 months, fading gradually Requires regular touch-ups to maintain results

See our full collection of before/after cases and detailed protocols on our dedicated website: rhinoplastiebruxelles.be.

FAQ: Medical Rhinoplasty

  • Why is a maxillofacial surgeon's expertise crucial for simple nose injections?
    The nose is one of the "high-risk" injection zones, due to the vascular connections between the facial artery, the dorsal nasal arteries, and the ophthalmic artery. A lack of understanding of the three-dimensional anatomy can lead to serious complications. Dr Yousefpour's surgical expertise ensures the injection plane is chosen with rigor and that safety protocols are applied immediately if needed.
  • Does hyaluronic acid make the nose bigger?
    Although hyaluronic acid does add a small amount of physical volume, aligning the hollows and smoothing the contour creates an optical effect where the nose appears finer, straighter, and better integrated into the harmony of the face.
  • Is the result permanent?
    No. Hyaluronic acid is a biocompatible, resorbable molecule. The average duration on the nasal bridge is 12 to 18 months, since this area moves far less than the lips or nasolabial folds.

Medical Information & Informed Consent Form: Medical Rhinoplasty (Hyaluronic Acid)

Procedure: Non-surgical nasal reshaping by injection of resorbable hyaluronic acid

Practitioner: Dr Afshin Yousefpour — Maxillofacial Surgeon & Facial Plastic Surgery

Medical information portal: rhinoplastiebruxelles.be

1. Treatment Objectives & Details

The hyaluronic acid injection aims to correct hollows, soften the appearance of a hump, project the nasal tip, or refine the profile lines. The product used is a resorbable, biocompatible medical device, lasting 12 to 18 months on average.

2. Expected Course, Side Effects, and Major Risks

Typical, temporary after-effects:

  • Redness, moderate swelling, and tenderness to touch for 24 to 48 hours.
  • Small bruises at the injection points.
  • Slight, temporary asymmetries related to swelling.

Shape-related uncertainties:

  • Over- or under-correction requiring an adjustment.
  • Minor product migration, or a temporary inflammatory nodule.

Serious vascular risks (essential, mandatory information):

  • Because of the direct vascular connections between the nose's vessels (dorsal nasal artery, angular artery) and the retro-orbital arterial network (ophthalmic artery / central retinal artery), injecting filler into the nose carries exceptional but very serious vascular risks: local skin necrosis from compression or embolization of a skin arteriole, and severe visual disturbances that can extend to irreversible one-sided blindness if the product migrates backward into the central retinal artery.
  • Safety measures: Dr Yousefpour uses high-safety techniques (pre-injection aspiration, slow micro-boluses in the deep sub-aponeurotic planes) and, if necessary, will perform a hyaluronidase injection to instantly dissolve the hyaluronic acid.

3. Post-Treatment Instructions

  • Do not massage or press on the treated area for 48 hours.
  • Avoid wearing heavy glasses resting on the nasal bridge for 48 to 72 hours.
  • Avoid exposure to intense heat (sauna, steam room, strong sun) and intense sport for 48 hours.
  • Contact Dr Yousefpour immediately in case of abnormal pain, mottled skin pallor, or sudden visual disturbance.

4. Patient's Formal Declaration and Consent

I, the undersigned,  , certify:

  1. That I was seen and examined in consultation by Dr Afshin Yousefpour, who presented the indications, achievable results, and anatomical limits of medical rhinoplasty.
  2. That I was explicitly informed of the after-effects, the vascular risks, and the extremely rare but serious complication of blindness (vision loss) linked to vascular embolization in the nasal region.
  3. That I was given an appropriate time to reflect and received clear answers to all my questions.
  4. That I have reviewed the information sheets and care guidelines on the dedicated website, rhinoplastiebruxelles.be.

Done in  , on:  

Patient's signature (preceded by the handwritten note "Read and approved"):

Surgical Rhinoplasty

Aesthetic, Functional & Reconstructive Nasal Surgery

Dr Afshin Yousefpour's structural excellence, in Brussels and Waterloo.

Surgical rhinoplasty is one of the most complex and fascinating procedures in facial plastic surgery. The nose is not a rigid block — it is an articulated biomechanical structure made up of bone, cartilage, ligaments, and mucosa in constant dynamic tension.

As a Maxillofacial Surgeon, Dr Afshin Yousefpour has full command of the face's bony and functional structures. His approach is built on structural, preservation-focused rhinoplasty: sculpting an elegant bridge and a well-defined tip while reinforcing the cartilage framework to preserve breathing function for life.

1. Primary Rhinoplasty (First-Time Surgery)

For patients who have never had nasal surgery before, primary rhinoplasty reshapes the nasal pyramid according to a tailor-made aesthetic plan:

  • Reducing a bony-cartilaginous hump: Millimeter-precise removal of excess bone and cartilage, without collapsing the triangular cartilages.
  • Shaping the nasal tip: Refining, projecting, de-projecting, or rotating the alar cartilages using shaping sutures and autologous cartilage struts (columellar strut).
  • Functional rhino-septoplasty: Straightening a deviated nasal septum (septoplasty) and treating the turbinates to restore a symmetrical, smooth airflow.
  • Open or closed approach: Chosen based on the patient's anatomy, hiding scars inside the nostrils or under the columella with absolute discretion.

2. Secondary & Tertiary Rhinoplasty (Complex Revisions)

Secondary rhinoplasty is for patients dissatisfied with the aesthetic result, or suffering from breathing obstruction, following one or more previous procedures performed elsewhere.

Specific technical challenges:

  • The presence of fibrous scar tissue and the loss of natural anatomical planes.
  • A lack of cartilage support due to excessive resection during the first surgery (an "inverted V" deformity, saddle nose, pinched tip, or alar retraction).
  • Reconstruction with autologous grafts: Dr Yousefpour uses cartilage grafts taken from the residual septum, the ear (conchal cartilage), or rib cartilage (spreader grafts, tip grafts, alar extension grafts) to rebuild the vaults and restore the nose's structural integrity.

Potential Complications & Risks: Primary and Secondary Surgery

Modern nasal surgery benefits from maximum operative safety, but requires complete transparency about surgical and scarring risks.

  • Bleeding: Possible in the first few hours, but usually very mild. If excessive, it may require additional nasal packing or, rarely, a return to the operating room.
  • Hematoma: May require drainage if large or too painful.
  • Infection: Despite the natural presence of germs in the nasal passages, it is very rare.
  • Unsightly scars: Can only affect external scars (when present), and very rarely disfiguring enough to require re-operation.
  • Skin damage: Rare but always possible, often caused by the nasal splint. Simple wounds or abrasions heal on their own, unlike skin necrosis, which is fortunately exceptional but often leaves a small scarred patch.
  • Septal perforation: If the nasal mucosa suffers, it can cause whistling breathing and repeated crusting.
  • Smell and taste disturbances: Usually temporary; exceptionally described as permanent.
  • Displacement or visibility of a cartilage graft: During rhinoplasty, cartilage grafts are placed to give the final shape, add volume, or correct a hollow — occasionally, this graft can shift or become visible. Re-operation isn't always necessary, but a complementary procedure is sometimes proposed.
  • Tear duct injury: Extremely rare; injury to the lacrimal duct causes watery eyes and requires a further procedure.
  • Cerebrospinal fluid leak: Exceptional; injury to the skull base can cause a CSF leak, carrying a risk of meningitis, requiring immediate intervention.
  • Secondary nose deviation: Very rarely, retractile, asymmetric scarring or graft displacement can cause a late deviation that may eventually require correction.
  • Persistent pain: Rhinoplasty pain is mild to moderate and resolves in most cases; rarely, some patients may experience severe, persistent pain.
  • Deep vein thrombosis and pulmonary embolism: Very rare; precautions are taken to minimize this risk.
  • Dissatisfaction with results: Can result from a misunderstanding about the goals, or from unusual scarring or unexpected tissue reactions such as poor spontaneous skin re-draping or retractile fibrosis. If poorly tolerated, these minor imperfections may eventually be corrected with a surgical touch-up — though such a touch-up cannot be performed before 1 year, to work on stabilized tissue after full scar maturation.

These risks should not be overstated. In expert hands, rhinoplasty remains, fortunately, a surgical procedure with few complications. That said, it's important to understand that any surgical procedure, even an apparently simple one, always carries a small element of chance.

Surgical Pathway & Clinical Course

  • Type of anesthesia: General anesthesia with hemodynamic control (controlled hypotension) to minimize post-operative bleeding and hematomas.
  • Duration: 1.5 to 2.5 hours for a primary rhinoplasty; 2.5 to 4 hours for a complex revision.
  • Stay: Outpatient surgery or a one-night stay, depending on the case.
  • Course & recovery: A thermoformed splint is worn for 7 to 10 days. Average social downtime of 8 to 10 days. 80% of swelling resolves after 2 to 3 months. The final shape is fully appreciable between 9 and 18 months (the time needed for complete skin retraction over the tip).

To explore our detailed clinical case files and plan a consultation at the practice, visit: rhinoplastiebruxelles.be.

FAQ: (Septo)Rhinoplasty Surgery

  • Why choose a maxillofacial surgeon for nasal surgery?
    Maxillofacial surgery incorporates a full analysis of the facial skeleton (forehead, nose, upper and lower jaw, dental occlusion). This expertise ensures that the change to your nose blends harmoniously with the proportions of your whole face, while also rigorously correcting septal deviations and airway valve abnormalities.
  • How long should I wait before considering a secondary rhinoplasty after a first unsatisfactory result?
    You must wait at least 12 months, and ideally 18 months for thicker skin. This time is needed for the inflammation to subside, the skin to soften, and internal healing to fully stabilize.
  • Is septum surgery reimbursed by health insurance?
    When the clinical and endonasal examination confirms an obstructive septal deviation or documented trauma sequela, the functional portion (septoplasty / fracture reduction) may be partially covered by health insurance and your supplementary/hospitalization insurance. The purely aesthetic portion remains the patient's responsibility.

Medical Information & Informed Consent Form: (Septo)Rhinoplasty Surgery

Procedure: Aesthetic Rhinoplasty / Functional Rhino-Septoplasty / Secondary Revision Rhinoplasty

Surgeon: Dr Afshin Yousefpour — Specialist in Maxillofacial & Facial Plastic Surgery

Clinical information portal: rhinoplastiebruxelles.be

1. Nature and Objectives of the Procedure

The procedure aims to modify the bony-cartilaginous architecture of the nose (hump reduction, tip refinement, axial realignment) and/or correct abnormalities of the nasal septum and airway valves (septoplasty, turbinoplasty). Nasal surgery is a highly precise discipline subject to the uncertainties of biological healing, tissue retraction, and cartilage memory. The surgeon has a heightened obligation to use best efforts, but no perfect morphological or functional result can be contractually guaranteed.

2. Detailed Potential Complications & Management Protocols

A. Post-Operative Bleeding and Epistaxis

Abnormal bleeding occurring within hours or the first days after surgery. Managed with clot evacuation, resorbable or non-resorbable hemostatic packing at the office or clinic, and pro-hemostatic agents (e.g. tranexamic acid). A return to surgery for hemostasis remains exceptional.

B. Septal Hematoma

A buildup of blood between the septal cartilage and its perichondrium, risking impaired blood supply to the cartilage. Managed with immediate drainage at the office under local anesthesia, followed by bilateral compressive packing and preventive antibiotic coverage to avoid chondritis or perforation.

C. Post-Operative Infection

A local infectious reaction at the surgical sites, incisions, or cartilage graft pockets. Managed with targeted broad-spectrum antibiotics, daily antiseptic local care, and drainage if there is a purulent collection.

D. Healing Disorders, Subcutaneous Fibrosis, and Tissue Retraction

Excessive scar thickening (notably on thick skin over the supratip area / "polly beak" deformity) or abnormal skin adhesions. Managed with specific draining massage, prolonged use of nightly compression strips, targeted local micro-dose steroid injections, or a later surgical revision if fibrosis persists after full maturation.

E. Residual Asymmetries, Palpable Bony or Cartilaginous Irregularities

Small bony ridges, palpable cartilage edges, or a slight residual deviation related to intrinsic scar tension forces. Managed with observation until stabilization (12 to 18 months); if the irregularity persists and causes real discomfort: bone rasping under local anesthesia, a cartilage camouflage graft, or precise hyaluronic acid micro-injection.

F. Intranasal Adhesions (Synechiae) & Persistent Airway Obstruction

A fibrous scar adhesion forming between the septum and the inferior turbinate, narrowing the nasal passage. Managed with in-office division of the adhesion under local anesthesia, and temporary placement of a silastic separator sheet for a few days.

G. Septal Perforation

An unhealed, bilateral tear in the septal mucosa creating a communication between the two nasal passages, sometimes causing whistling or crusting. Managed with saline rinses and healing ointments; if symptomatic, surgical closure with mucosal advancement flaps or a medical silicone septal button.

H. Transient or Persistent Sensory Disturbances

Reduced sensation (hypoesthesia) of the nasal tip, upper lip, or upper incisors from stretching of superficial nerve fibers. Recovers spontaneously and progressively over 6 to 12 months in nearly all cases.

3. Financial Framework for Revision Surgery (Touch-Ups)

Internal healing of the nose continues for 12 to 18 months. No definitive surgical touch-up can be undertaken before this full tissue-stabilization period.

  • Terms for covering revisions: If a touch-up or revision surgery proves necessary later to correct a residual imperfection, all costs related to this new procedure (clinic/hospital fees, anesthetist's fees, consumables, operating room equipment, and surgical fees) remain entirely and exclusively the patient's responsibility.
  • The initial surgical procedure never constitutes a package that includes any future secondary procedures.

4. Legal Provisions & Belgian Taxation (VAT)

  • 21% VAT applies: In accordance with Belgian tax law governing medical and surgical procedures (VAT Code, Art. 44, §1, 2°), any procedure or portion of a procedure that is purely aesthetic is mandatorily subject to 21% VAT, charged in addition to fees and facility costs.
  • Mixed / functional procedures: Only the strictly reconstructive or functional component (e.g. septoplasty for a documented obstruction, reduction of a traumatic fracture), documented and coded according to national health insurance criteria, can be exempt from VAT. The associated aesthetic portion is always billed separately and subject to 21% VAT.

5. Patient's Commitment and Formal Consent

I, the undersigned,  , certify and declare:

  • That I was seen and examined in an in-depth consultation by Dr Afshin Yousefpour.
  • That I have fully reviewed all the possible complications listed above, their management, and the morphological limits dictated by my starting anatomy.
  • That I understand and accept that any revision/touch-up surgery is entirely at my own financial expense, and that aesthetic procedures are legally subject to 21% Belgian VAT.
  • That I was given sufficient time to reflect before signing, and received satisfactory answers to all my questions.
  • That I have reviewed the explanatory sheets and care protocols on the reference website: rhinoplastiebruxelles.be.

Done in  , on:  

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