Challenges of surgical rhinoplasty in a nose previously filled with hyaluronic acid

Abstract

Objective: To evaluate the complications arising from the application of hyaluronic acid in rhinomodelation procedures and how the presence of this filler impacts the actions in a future surgical rhinoplasty intervention and the care that the surgeon must have during the procedure. Literature review: Granuloma is an important, late and rare adverse event. Cutaneous necrosis is one of the most serious and feared early complications. Vascular events can result in permanent sequelae. Nose dissection with the presence of residual filling may generate difficulties in the procedure. The actions taken may undergo modifications over time, altering the final result. What was previously injected should be evaluated, the application layer and consider the possibility of presence of fibrocicatricial tissue. Final considerations: Surgeons should verify the occurrence of previous interventions such as fillers. You can use ultrasound and/or transluminescence to detect location, volume, tissue fibrosis and other factors that may affect the final result.