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Facial Plast Surg
DOI: 10.1055/a-2466-1407
Original Research

Effect of Facial Fillers on Post-rhinoplasty edema: A Hypothesis Based on Literature Review

Salwa Al Maamari
1   Department of Facial Plastic and Reconstructive Surgery, Institute of Medical Sciences, Canterbury Christ Church University, Kent, United Kingdom
2   Department of Facial Plastic and Reconstructive Surgery, University Hospital Lewisham, London, United Kingdom
,
Géraldine Vansteelant 
2   Department of Facial Plastic and Reconstructive Surgery, University Hospital Lewisham, London, United Kingdom
,
Shirrushtii Appan
3   Department of Burns, Hands and Plastics Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
,
Alwyn R. D'Souza
4   Division of ENT/Head and Neck/Facial Plastic and Reconstructive Surgery, Department of Aesthetic Facial Surgery, Institute of Medical Sciences, Canterbury Christ Church University, Kent, United Kingdom
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Abstract

The quest to achieve younger and media-driven facial aesthetics has resulted in an exponential increase in the use of facial fillers. Inevitably, this has meant that it is now commonplace for facial plastic surgeons to have patients with fillers in the face. In the senior author's experience (A.R.D.), it was observed that patients with facial fillers experienced persistent edema post-rhinoplasty. It was, therefore, hypothesized that this prolonged edema may be related to fillers affecting the lymphatic drainage impacting postoperative edema following facial surgery.

This article aims to gather evidence from wider literature to support the hypothesis that fillers do indeed compromise lymphatic drainage. A narrative literature review was performed using selective articles on fillers and post-rhinoplasty edema. A methodological analysis was then followed to develop a standard theory characterized through the discussion.

It is theorized that due to their hydrophilic characteristics, hardness, volume, and backflow phenomena, hyaluronic acid fillers can lead to prolonged edema. In addition, they can either directly block or indirectly exert pressure on the lymphatic pathways and hinder drainage.

The research findings support the hypothesis that facial fillers impact postoperative facial edema. Further research is required to objectively measure the effect of fillers on facial lymphatic drainage.

The level of evidence is IV.

Keywords

hyaluronic acid fillers - rhinoplasty - prolonged post-rhinoplasty edema - facial fillers - persistent edema - facial edema - lymphatic channels


Publication History

Accepted Manuscript online:
12 November 2024

Article published online:
03 December 2024

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