The potential benefits and risks of soft tissue fillers as an adjunct to surgical reshaping of the nose is the topic of a recent article in the November/December issue of Aesthetic Surgery Journal.
According to ASAPS statistics, rhinoplasty is among the top five surgical cosmetic procedures, with 152,434 procedures performed in 2008. With the growing availability, variety, and popularity of filler materials, it stands to reason that the potential use of these products in conjunction with nose reshaping would be explored, says Steven Dayan, MD, one of the article’s three authors and clinical assistant professor in the Department of Otolaryngology, University of Illinois Medical Center in Chicago.
Hyaluronic acid (HA), calcium hydroxylapatite gel (CaHA), and liquid silicone (all used off-label) have been used to treat nasal deformities with varying degrees of success, Dayan et al write. Silicone is generally not recommended, however, because of the greater risk of severe complications such as nodules, cellulitis and ulceration. “The use of any soft tissue filler in the nose should always be approached with caution and with thorough consideration of a patient’s individual circumstances,” says Dayan.
As with all injectable filler treatments, technique is paramount to success. Limiting the use of fillers to the top and sides of the nose while generally avoiding the base and tip, and placing the fillers at the proper depth in the skin, are important for minimizing complications such as a bumpy appearance, soft tissue damage, or compromising of the blood vessels in the nose.
While soft tissue fillers may be an effective treatment for certain post-surgical deformities, they are generally not recommended as a first-line option for nasal reshaping — they are also not recommended for patients considering revision surgery, since persistent material in the nose may complicate a future procedure.