Paranasal augmentation — filling the area beside the nose where the maxilla meets the pyriform aperture — addresses midface concavity that many patients attribute to nose shape but actually results from underlying skeletal structure. Korean cosmetic surgery uses implants, fillers, or fat grafting in this often-overlooked area. This guide explains the procedure.
What paranasal augmentation addresses
- Sunken midface (paranasal depression).
- Hollow appearance beside nose.
- Deep nasolabial folds from underlying recession.
- Apparent flat midface profile.
- Often combined with rhinoplasty for harmony.
Why this area becomes sunken
- Genetic skeletal recession (common in Asian patients).
- Maxillary hypoplasia.
- Aging-related bone resorption.
- Significant weight loss.
- Post-surgical midface flattening.
How it differs from common misattribution
- Patients often think their nose looks "wide" or flat.
- Actually paranasal area is recessed.
- Augmenting paranasal area improves "nose" appearance.
- More effective than aggressive rhinoplasty alone.
- Comprehensive midface reshape.
Treatment options
Paranasal implants
- Most common Korean approach.
- Silicone or Medpor materials.
- Custom-shaped to anatomy.
- Permanent solution.
- Predictable results.
Hyaluronic acid filler
- Non-surgical option.
- Immediate results.
- Reversible with hyaluronidase.
- Lasts 12-18 months.
- Maintenance required.
Fat grafting
- Autologous fat transfer.
- Natural feel and appearance.
- Variable fat survival.
- Multiple sessions sometimes needed.
- Combined with other facial fat grafting.
Sculptra (PLLA)
- Collagen stimulator.
- Gradual volume restoration.
- Longer-lasting than HA.
- Series of sessions.
Surgical implant procedure
Approach
- Upper gingivobuccal sulcus incision (inside mouth).
- No external scar.
- Subperiosteal dissection.
- Pocket created beside pyriform aperture.
- Custom implant placed.
- Closure inside mouth.
Anesthesia
- Local anesthesia with monitored sedation typical.
- General anesthesia if combined with major procedures.
- 30-60 minutes typical procedure time.
Recovery
- Soft food 1-2 weeks.
- Mouth rinses for hygiene.
- Initial swelling 1-3 weeks.
- Final shape settles 3-6 months.
- No external visible recovery.
Combined with rhinoplasty
- Often paired procedures.
- Comprehensive midface reshape.
- Better than rhinoplasty alone for some patients.
- Single surgical session.
- Korean signature combined approach.
Material considerations
Silicone
- Smooth, easy to remove.
- Long-history use.
- Predictable shape.
- No tissue ingrowth.
Medpor (porous polyethylene)
- Tissue ingrowth.
- Stable position.
- Difficult to remove.
- Lower migration risk.
Custom 3D-printed
- Patient-specific shape.
- Premium option.
- Best fit.
- Higher cost.
Pricing in Korean clinics 2026
- Paranasal implant surgery: ₩2,500,000–₩5,500,000.
- Combined with rhinoplasty: package pricing.
- Filler-based: ₩400,000–₩900,000 per syringe.
- Fat grafting: ₩2,000,000–₩4,500,000.
- USD: $1,900–$4,200 typical implant range.
Risks specific to paranasal augmentation
- Implant migration (rare).
- Infection (mouth incision risk).
- Sensation changes (typically temporary).
- Dental complications (rare).
- Asymmetry.
- Need for revision.
Who is a good candidate
- Sunken paranasal area visible.
- Stable preference for change.
- Realistic expectations.
- Healthy gums and oral hygiene.
- No active dental issues.
- Comprehensive midface concerns.
For international patients
- 10–14 days minimum stay.
- Soft food during recovery.
- Combined with other facial procedures often.
- Long-term follow-up at home.
- Photographic comparison.
What patients should know
- Often more impactful than nose surgery alone.
- Permanent change with implants.
- Subtle but meaningful improvement.
- Combined approach common.
- Korean specialty area.
The honest framing
Paranasal augmentation addresses an often-overlooked aesthetic concern that many patients misattribute to nose shape — the sunken paranasal area can dramatically improve overall midface harmony. The patients who do well work with surgeons who recognize this anatomy, choose conservative implant sizes, and consider combined procedures with rhinoplasty when appropriate. The patients who pursue aggressive rhinoplasty without addressing paranasal recession often have suboptimal aesthetic outcomes despite technically successful nose surgery. Korean specialty clinics offer this procedure with refined technique and competitive pricing.