Injecting soft-tissue fillers in the nose requires a very specific approach, as vascular-related adverse events are a pivotal concern. This study describes a novel standardized 4-step treatment algorithm for safe, reproducible, and effective liquid rhinoplasty procedures using a “deep columellar approach.” Medical records of n = 511 treatments were retrospectively analyzed with respect to the occurrence and severity of adverse events. The low rate and severity reported for such incidents can be correlated to a precise and verifiable filler placement in the deep, supraperiosteal, and supraperichondrial layers, using blunt cannulas.