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Nasal Filling in Plastic Surgery Practice: Primary Nasal Filling, Nasal Filling for Post-rhinoplasty Defects, Rhinoplasty After Hyaluronidase Injection in Dissatisfied Nasal Filling Patients

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  • Rhinoplasty
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Abstract

Background

Nasal filling has gained popularity in plastic surgery practice and strengthened the surgeon's hand. Mild deformities of the nose can be treated with nasal filling instead of rhinoplasty, or small contour irregularities following surgical rhinoplasty can be corrected by dermal filler injections. It is a significant advantage of hyaluronic acid (HA) fillers that they can be dissolved with hyaluronidase in case of the patient dislikes the appearance and desires a surgical rhinoplasty. However, there is no publication about when rhinoplasty surgery can be performed safely after hyaluronidase injection.

Objectives

In this case series, we shared our experiences with nasal filling in plastic surgery practice under three headings: primary nasal filling, nasal filling for post-rhinoplasty defects and rhinoplasty after hyaluronidase injection in dissatisfied filling patients. We presented our nasal filling technique, indications, result analysis and also our rhinoplasty experiences we performed at different times after hyaluronidase injection.

Methods

Nasal filling patients from July 2015 to March 2020 were divided and analyzed in three groups: (a) Primary nasal filling was provided to 62 patients, (b) nasal filling for post-rhinoplasty defect was provided to 18 patients, and (c) rhinoplasty after hyaluronidase injection was performed in five patients who are not satisfied with results. The duration between hyaluronidase and rhinoplasty operation was, respectively, 6 months, 3 months, 3 months, 2 months and 1 week.

Results

(a) In primary nasal filling, 57 patients were fully satisfied, two patients were satisfied, and three patients were dissatisfied with results. Results were stable up to at least 6 months (Range 6–14 months). (b) In nasal filling for post-rhinoplasty defects, all patients were fully satisfied with results. Results were stable for at least 12 months (Range 12–36 months). (c) In rhinoplasty after hyaluronidase injection, any filling residue was not observed, and there were no complications. The postoperative results were satisfactory.

Conclusion

Nasal filling with hyaluronic acid represents an excellent alternative for patients who do not wish to undergo a rhinoplasty or a revision rhinoplasty procedure. HA filler can be dissolved easily with hyaluronidase if the patient does not like the result, and we think that rhinoplasty can be performed safely at least one week later from hyaluronidase treatment.

Level of Evidence IV

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References

  1. ASAPS: Cosmetic (aesthetic) surgery national data bank statistics (2018) https://www.surgery.org/sites/default/files/ASAPS-Stats2018_0.pdf

  2. Rauso R, Tartaro G, Chirico F, Zerbinati N, Albani G, Rugge L (2020 Mar) Rhinofilling with hyaluronic acid thought as a cartilage graft. J Craniomaxillofac Surg 48(3):223–228

    Article  Google Scholar 

  3. Kontis TC (2018) The art of camouflage: when can a revision rhinoplasty be nonsurgical. Facial Plast Surg 34(3):270–277

    Article  CAS  Google Scholar 

  4. Stupak HD, Moulthrop TH, Wheatley P, Tauman AV, Johnson CM Jr (2007) Calcium hydroxylapatite gel (Radiesse) injection for the correction of postrhinoplasty contour deficiencies and asymmetries. Arch Facial Plast Surg 9(02):130–136

    Article  Google Scholar 

  5. De Lorenzi C (2014) Complications of injectable fillers, part 2: vascular complications. Aesthet Surg J 34(4):584–600

    Article  Google Scholar 

  6. Jasin ME (2013 May) Nonsurgical rhinoplasty using dermal fillers. Facial Plast Surg Clin North Am 21(2):241–252

    Article  Google Scholar 

  7. Soparkar C, Patrinely J (2007) Hyaluronidase and restylane. Arch Facial Plast Surg 9:299–300

    Article  Google Scholar 

  8. Menon H, Thomas M, D’silva J (2010) Low dose of hyaluronidase to treat over correction of HA filler-a case report. J Plast Reconstr Aesthetic Surg 63:416–417

    Article  Google Scholar 

  9. Buhren BA, Schrumpf H, Hoff NP, Bölke E, Hilton S, Gerber PA (2016) Hyaluronidase: from clinical applications to molecular and cellular mechanisms. Eur J Med Res 21:5

    Article  Google Scholar 

  10. King M, Convery C, Davies E (2018) The use of hyaluronidase in aesthetic practice. J Clin Aesthet Dermatol 11(6):428–434

    Google Scholar 

  11. Bektas G (2019) Lateral crural steal and set back combination for different types of nasal tip. Akd Tıp D / Akd Med J / 1:143–150

    Google Scholar 

  12. Knapp TR, Vistnes LM (1985) The augmentation of soft tissue with injectable collagen. Clin Plast Surg 12:221–225

    Article  CAS  Google Scholar 

  13. Webster RC, Hamdan US, Gaunt JM et al (1986) Rhinoplastic revisions with injectable silicone. Arch Otolaryngol Head Neck Surg 112:269–276

    Article  CAS  Google Scholar 

  14. Han SK, Shin SH, Kang HJ et al (2006) Augmentation rhinoplasty using injectable tissue-engineered soft tissue. Ann Plast Surg 56:251–255

    Article  CAS  Google Scholar 

  15. Beer KR (2006) Nasal reconstruction using 20mg/mL cross-linked hyaluronic acid. J Drugs Dermatol 5:465–466

    PubMed  Google Scholar 

  16. Heden P (2016) Nasal reshaping with hyaluronic acid: an alternative or complement to surgery. Plast Reconstr Surg Glob Open 4(11):e1120

    Article  Google Scholar 

  17. Rohrich RJ, Ghavami A, Crosby MA (2007) The role of hyaluronic acid fillers (Restylane) in facial cosmetic surgery: review and technical considerations. Plast Reconstr Surg 120(6 Suppl):41S–54S

    Article  CAS  Google Scholar 

  18. Johnson ON 3rd, Kontis TC (2016 Oct) Nonsurgical rhinoplasty. Facial Plast Surg 32(5):500–506

    Article  CAS  Google Scholar 

  19. Kurkjian TJ, Ahmad J, Rohrich RJ (2014 Feb) Soft-tissue fillers in rhinoplasty. Plast Reconstr Surg 133(2):121–126

    Article  Google Scholar 

  20. Papakonstantinou E, Roth M, Karakiulakis G (2012) HA: a key molecule in skin aging. Dermatoendocrinol 4(3):253–258

    Article  CAS  Google Scholar 

  21. de Lacerda DA, Zancanaro P (2007) Filler rhinoplasty. Dermatol Surg. 33(Suppl 2):S207–S212 discussion S212

    PubMed  Google Scholar 

  22. Bray D, Hopkins C, Roberts DN (2010 Jun) Injection rhinoplasty: non-surgical nasal augmentation and correction of post-rhinoplasty contour asymmetries with hyaluronic acid: how we do it. Clin Otolaryngol 35(3):227–230

    Article  CAS  Google Scholar 

  23. Filippova OV, Afonichev KA, Krasnogorsky IN, Vashetko RV (2017) Clinical and morphological characteristics of the vascular bed of hypertrophic scar tissue in different periods of its formation. Pediatr Traumatol Orthop Reconstr Surg 5(3):25–35

    Article  Google Scholar 

  24. Bailey SH, Fagien S, Rohrich RJ (2014) Changing role of hyaluronidase in plastic surgery. Plast Reconstr Surg 133(2):127e–132e

    Article  CAS  Google Scholar 

  25. Robati RM, Moeineddin F, Almasi-Nasrabadi M. The risk of skin necrosis following hyaluronic acid filler injection in patients with a history of cosmetic rhinoplasty. Aesthet Surg J. 2018.

  26. Kim DW, Yoon ES, Ji YH, Park SH, Lee BI, Dhong ES (2011) Vascular complications of HA fillers and the role of hyaluronidase in management. J Plast Reconstr Aesthet Surg 64(12):1590–1595

    Article  Google Scholar 

  27. Lambros V (2004) The use of hyaluronidase to reverse the effects of hyaluronic acid filler. Plast Reconstr Surg 114(1):277

    Article  Google Scholar 

  28. Soparkar CN, Patrinely JR, Tschen J (2004) Erasing restylane. Ophthal Plast Reconstr Surg 20(4):317–318

    Article  Google Scholar 

  29. Cohen JL, Biesman BS, Dayan SH, DeLorenzi C, Lambros VS, Nestor MS et al (2015) Treatment of Hyaluronic Acid Filler-Induced Impending Necrosis With Hyaluronidase: Consensus Recommendations. Aesthet Surg J 35(7):844–849

    Article  Google Scholar 

  30. DeLorenzi C (2014) Transarterial degradation of hyaluronic acid filler by hyaluronidase. Dermatol Surg 40(8):832–841

    Article  CAS  Google Scholar 

  31. DeLorenzi C (2017) New High Dose Pulsed Hyaluronidase Protocol for Hyaluronic Acid Filler Vascular Adverse Events. Aesthet Surg J 37(7):814–825

    Article  Google Scholar 

  32. Longaker MT, Chiu ES, Adzick NS, Stern M, Harrison MR, Stern R (1991) Studies in fetal wound healing. V. A prolonged presence of hyaluronic acid characterizes fetal wound fluid. Ann Surg 213:292–296

    Article  CAS  Google Scholar 

  33. Brody H (2005) Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement. Dermatol Surg 31:893–897

    Article  CAS  Google Scholar 

  34. Fallacara A, Baldini E, Manfredini S, Vertuani S (2018) Hyaluronic acid in the third millennium. Polymers 10:701

    Article  Google Scholar 

Download references

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Correspondence to Gamze Bektas.

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Bektas, G., Cinpolat, A. & Rizvanovic, Z. Nasal Filling in Plastic Surgery Practice: Primary Nasal Filling, Nasal Filling for Post-rhinoplasty Defects, Rhinoplasty After Hyaluronidase Injection in Dissatisfied Nasal Filling Patients. Aesth Plast Surg 44, 2208–2218 (2020). https://doi.org/10.1007/s00266-020-01895-9

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