"Dou-gong" Technique: A Novel Biomechanical Approach to Injection Rhinoplasty Based on Nasal Ligament Anatomy.

Abstract

Background: Traditional injection rhinoplasty often prioritizes superficial volume augmentation, which can lead to unnatural nasal contours, transient aesthetic effects, and various complications.

Objective: This study introduces the "Dou-gong" technique, a novel biomechanical approach to injection rhinoplasty inspired by ancient Chinese architecture, and evaluates its clinical efficacy in enhancing nasal contour through nasal ligament support.

Methods: A retrospective analysis was performed on 100 patients who underwent the "Dou-gong" injection procedure between January and December 2025. The technique targets five precise anatomical zones: the tip, supratip, dorsum, radix, and columella base. Hyaluronic acid was delivered above the periosteum or perichondrium using a 27-G sharp needle to reinforce the structural support of the nasal ligaments. Clinical outcomes were assessed using the Rhinoplasty Outcome Evaluation (ROE) questionnaire and visual analogue scale (VAS) for pain, swelling, and overall satisfaction. Objective outcomes were presented by photogrammetric analysis through 4 nasal landmark parameters.

Results: All 100 patients demonstrated improvements in nasal aesthetics. VAS scores indicated high levels of patient satisfaction, accompanied by minimal procedural pain and postoperative swelling. No severe complications, such as vascular occlusion or material displacement, were observed during the follow-up period.

Conclusion: The "Dou-gong" technique provides a preliminary, feasible alternative in non-surgical rhinoplasty by shifting the clinical focus from mere volume accumulation to biomechanical ligament reinforcement. Future prospective, randomized controlled investigations are required to evaluate efficacy and benchmark performance against conventional injection modalities.

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