Abstract
Hyaluronic acid dermal fillers for nasolabial fold correction are generally safe, but rare complications can occur. We present the first reported case of an internal nasal valve collapse following nasolabial fold augmentation with hyaluronic acid filler in a 50-year-old woman with mild septal deviation. The patient developed unilateral nasal obstruction and noisy breathing 3 days post-injection. Examination confirmed collapse of the left internal nasal valve during deep inspiration, which resolved with lateral cheek support. Conservative management, including warm compresses, firm downward massage, and intranasal corticosteroid spray, resolved symptoms by day 20 post-procedure without the need for hyaluronidase. The aesthetic result remained satisfactory. This case highlights the importance of thorough anatomical assessment before midface filler injections and prompt recognition of unexpected functional complications. Awareness of nasal valve dynamics and careful injection technique near the pyriform aperture can help prevent such events.