Abstract
BACKGROUND: This study aims to assess the anatomical positioning of critical nasal arteries in Chilean patients to improve the safety and efficacy of nonsurgical rhinoplasty procedures. OBJECTIVES: Using Doppler ultrasound, the study seeks to provide a precise vascular map that informs injection protocols and minimizes the risk of vascular complications, particularly in high-risk nasal regions. METHODS: A cohort of 50 Chilean patients (ages 18-60, BMI 18.5-24.9 kg/m²) with no previous nasal procedures were evaluated. Doppler ultrasound was used to map the nasal vasculature, specifically targeting the dorsal nasal artery (DNA), radix, columella, and facial arteries in the piriform fossa. Key measurements included the depth of each artery relative to the periosteum and the skin surface. Descriptive statistics were used to calculate mean values and standard deviations for arterial distances, and comparative analyses were performed using the Student's t test or Mann-Whitney U test as appropriate, with a significance threshold set at P < .05. RESULTS: The anatomical mapping revealed significant variability in arterial positioning. The DNA was located within 1 mm of the periosteum in 10% of cases, presenting a high risk for vascular complications if not accurately mapped preinjection. The average depth of the facial artery in the piriform fossa was 4.65 ± 0.48 mm on the left side and 4.08 ± 0.53 mm on the right side, with statistically significant differences observed between sides (P < .01). Additionally, the columellar artery showed variability in proximity to the epidermis, averaging 2.42 ± 0.34 mm on the left side and 3.03 ± 0.37 mm on the right (P = .03). These findings underscore the necessity of individualized depth and site adjustments during injections to mitigate risks associated with arterial proximity. CONCLUSIONS: This study provides critical insights into nasal vascular anatomy in a Latin American population, highlighting the clinical importance of Doppler ultrasound for preinjection mapping in nonsurgical rhinoplasty. By identifying high-risk areas and statistically significant anatomical variations, this research supports the need for a standardized, evidence-based protocol tailored to individual vascular profiles. The integration of Doppler ultrasound into clinical practice is recommended to enhance patient safety and optimize aesthetic outcomes, establishing a new standard for injectable procedures in high-risk nasal regions.