Facial Plast Surg 2015; 31(03): 301-307
DOI: 10.1055/s-0035-1555628
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Injection Rhinoplasty with Hyaluronic Acid and Calcium Hydroxyapatite: A Retrospective Survey Investigating Outcome and Complication Rates

Bernd Schuster
1   Private Clinic for ENT and Facial Plastic Surgery, Munich, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
30 June 2015 (online)

Abstract

Injection rhinoplasty offers an attractive, reversible alternative to surgery. Here we assessed outcome, longevity of benefits, adverse effects, and patient assessment of injection rhinoplasty, using degradable synthetic fillers. Forty-six patients who underwent injection rhinoplasty using degradable fillers over the past 3 years were assessed (calcium hydroxyapatite: 26 patients, hyaluronic acid: 20 patients). Comparison of pre- and postoperative images indicated realistically achievable treatment results. Patient satisfaction was assessed using a 5-point questionnaire at 3 weeks and 9 months posttreatment. Forty-six patients (88 areas) were treated. At 3 weeks posttreatment, 85% of patients were satisfied with treatment results. At 9 months or later posttreatment, 87% of patients were very/completely satisfied with treatment results, regardless of filler used. Treatment longevity varied between 6 and 30 months (mean: 13.5 months). Positive evaluation was mainly due to accurate prediction of achievable results to meet patient expectations. There were one moderate and two severe complications, all following calcium hydroxyapatite treatment. Two resolved completely following treatment and one patient was lost to follow-up. This resulted in subsequent exclusive use of hyaluronic acid filler. Injectable biodegradable fillers are effective for correction of minor nasal deformities or irregularities. Attention must be given to injection technique and adverse effect management.

 
  • References

  • 1 Sundaram H, Voigts B, Beer K, Meland M. Comparison of the rheological properties of viscosity and elasticity in two categories of soft tissue fillers: calcium hydroxylapatite and hyaluronic acid. Dermatol Surg 2010; 36 (Suppl. 03) 1859-1865
  • 2 Jasin ME. Nonsurgical rhinoplasty using dermal fillers. Facial Plast Surg Clin North Am 2013; 21 (2) 241-252
  • 3 Bernardin A. VYCROSS™: An Innovative Dermal Filler Technology. Poster Presentation at Anti-aging Medicine European Congress (AMEC), Monte Carlo; 2013
  • 4 Rivkin A. A prospective study of non-surgical primary rhinoplasty using a polymethylmethacrylate injectable implant. Dermatol Surg 2014; 40 (3) 305-313
  • 5 Lazzeri D, Agostini T, Figus M, Nardi M, Pantaloni M, Lazzeri S. Blindness following cosmetic injections of the face. Plast Reconstr Surg 2012; 129 (4) 995-1012
  • 6 Cheney ML, Blair PA. Blindness as a complication of rhinoplasty. Arch Otolaryngol Head Neck Surg 1987; 113 (7) 768-769
  • 7 Leng T, Moshfeghi DM. Branch retinal artery occlusion after septoplasty. Ophthalmic Surg Lasers Imaging 2010; Dec 1;41 Online:e1-e2
  • 8 Kim EG, Eom TK, Kang SJ. Severe visual loss and cerebral infarction after injection of hyaluronic acid gel. J Craniofac Surg 2014; 25 (2) 684-686
  • 9 Chen Y, Wang W, Li J, Yu Y, Li L, Lu N. Fundus artery occlusion caused by cosmetic facial injections. Chin Med J (Engl) 2014; 127 (8) 1434-1437
  • 10 Saban Y, Andretto Amodeo C, Bouaziz D, Polselli R. Nasal arterial vasculature: medical and surgical applications. Arch Facial Plast Surg 2012; 14 (6) 429-436
  • 11 Kim SK, Hwang K. A surgeon's legal liability of compensation for blindness after periorbital fat grafts. J Craniofac Surg 2013; 24 (3) 970-971
  • 12 DeLorenzi C. Transarterial degradation of hyaluronic acid filler by hyaluronidase. Dermatol Surg 2014; 40 (8) 832-841
  • 13 Schumacher M, Schmidt D, Jurklies B , et al; EAGLE-Study Group. Central retinal artery occlusion: local intra-arterial fibrinolysis versus conservative treatment, a multicenter randomized trial. Ophthalmology 2010; 117 (7) 1367-75.e1
  • 14 Matarasso SL, Carruthers JD, Jewell ML ; Restylane Consensus Group. Consensus recommendations for soft-tissue augmentation with nonanimal stabilized hyaluronic acid (Restylane). Plast Reconstr Surg 2006; 117 (3, Suppl): 3S-34S , discussion 35S–43S
  • 15 Kurkjian TJ, Ahmad J, Rohrich RJ. Soft-tissue fillers in rhinoplasty. Plast Reconstr Surg 2014; 133 (2) 121e-126e