Post‐rhinoplasty complications with previous hyaluronic acid injection history: Cerebral infarction and vision loss

Abstract

BackgroundRhinoplasty is becoming increasingly frequent as the pursuit of aesthetics by people accelerates. In recent years, the proportion of people opting for rhinoplasty injections has gradually increased. This has led to numerous reports citing catastrophic postoperative complications such as skin necrosis, cerebral infarction, and visual impairment.AimThe aim of our report is to discuss the possible etiological factors for this post‐rhinoplasty complication and provides a rationale for HA injection history as a risk factor in rhinoplasty.MethodsWe report a rare case that received nasal HA injections in the past without any untoward incident. She opted for a second rhinoplasty 2 years after her initial nasal HA injections. This second intervention led to post‐injection loss of vision in one eye and cerebral infarction. Following clinical and radiological examination, digital subtraction angiography (DSA) and superselective intra‐arterial thrombolysis were performed.ResultsThe patient did not develop disuse exotropia or ocular atrophy, but the left eye remained without light perception, which implies that intra‐arterial thrombolytic therapy may be a positive and effective method to maintain the normal appearance of the eye.ConclusionIt is advisable for patient safety to maintain a long interval of time between hyaluronidase injection and repeat rhinoplasty. Clinicians should become familiar with the anatomical peculiarities of the patient and be gentle during the rhinoplasty procedure.

Delayed Diagnosis of Septal Ulcer after Hyaluronic Acid Nasal Filler Injection

“…2 While HA injections are generally deemed safe, there have been rare reports of serious complications such as vascular embolism, cerebral infarction, and visual impairment. 3 We recently encountered a patient with a prior history of HA injections who developed a severe septal ulcer secondary to local ischemia due to arterial occlusion after the HA nasal filler injection. The condition was identified with the aid of nasal endoscopy and imaging studies.…”

“…Within the field of rhinoplasty, the filler injection approach using hyaluronic acid (HA) has gained popularity due to its simplicity, affordability, and minimal recovery time 2 . While HA injections are generally deemed safe, there have been rare reports of serious complications such as vascular embolism, cerebral infarction, and visual impairment 3 . We recently encountered a patient with a prior history of HA injections who developed a severe septal ulcer secondary to local ischemia due to arterial occlusion after the HA nasal filler injection.…”