Case Background: The Overlooked "Mid-Facial Depression"

Many patients seeking aesthetic enhancements often focus their attention on the height of the nasal bridge or the shape of the nasal tip, while neglecting the cornerstone of facial three-dimensionality—the nasal base. In this case, patient A (pseudonym), although possessing a moderate nasal bridge height, still appeared flat from the side profile and exhibited noticeable nasolabial folds and a visual protrusion of the mouth. After professional clinical assessment, it was determined that the core issue was not insufficient nasal height, but rather low skeletal foundation on both sides of the alar wings and below the nostrils, which is a typical case of "nasal base depression."

Aesthetic Analysis: Why Filling the Nasal Base is Crucial?

The nasal base is located beneath the nose and above the upper lip, serving as the "foundation" for the nose. If the foundation is sunken, even if a tall "building" (rhinoplasty) is constructed, the overall facial appearance lacks depth. Nasal base depression typically causes the following visual issues:

Pseudo-protruding mouth: Due to the depression in the mid-face, the teeth and lips appear relatively prominent. Even with straight teeth, the side profile may still resemble that of someone with buck teeth.
Deepened nasolabial folds: Soft tissues on both sides of the alar wings lack skeletal support, making it easy to form deep nasolabial folds, giving an aged appearance.
Lack of facial dimensionality: A flat mid-face area causes features to appear scattered and less refined.

Treatment Plan: Precise Layering and Moderate Filling

Addressing Patient A's condition, we developed a comprehensive plan centered on improving mid-facial depression. Considering that the nasal base area is rich in expressions and frequent muscle activity, requiring high support and stability from materials, we ultimately chose hyaluronic acid with high cohesiveness and good supportive properties for suprapériosteal injection.

During the procedure, the doctor strictly adhered to the principle of "small amounts multiple times, deep support":

Precise targeting: Primary injection points were located deep outside the alar wings and below the nostrils, avoiding vascular-rich areas to ensure safety.
Layer control: Materials were injected into the upper layer of the periosteum to simulate skeletal support effects, avoiding displacement or stiffness caused by superficial injection.
Natural transition: Emphasis was placed on blending with surrounding tissues. Rather than pursuing extreme fullness, natural physiological curves were restored to avoid creating a "monkey-like" appearance or stiff expressions.

Post-Operative Feedback: Subtle yet Significant Changes

Immediately after surgery, Patient A experienced a noticeable uplift in her mid-face. From the side profile, the previously depressed alar base was filled, nasolabial folds visually lightened, and the illusion of a protruding mouth was significantly improved. More importantly, these changes were subtle and natural, lacking exaggerated cosmetic traces; friends simply remarked that she looked more energetic and younger.

One week later during follow-up, swelling had completely subsided, and the shape stabilized. Patient A stated that she no longer needed to deliberately find angles to hide her flat mid-face when taking photos, leading to a significant boost in confidence.

Physician's Message

Filling the nasal base is a procedure with extremely high demands for aesthetics and technique. It is not merely "filling pits," but reconstructing and optimizing the skeletal structure of the mid-face. Too much can be as bad as too little; excessive filling can lead to stiff facial expressions or even a "simian" appearance. Therefore, choosing an experienced doctor, undergoing personalized aesthetic design, and making moderate improvements under safe conditions are key to achieving natural beauty.

Note: Aesthetic results vary by individual. This case is for reference only. Specific treatment plans should be based on professional medical consultation.

Korea Seyan Dermatology HospitalCredentials