Soft Tissue Fillers in the Nose

Abstract

Using soft tissue fillers to correct postrhinoplasty deformities in the nose is appealing. Fillers are minimally invasive and can potentially help patients who are concerned with the financial expense, anesthetic risk, or downtime generally associated with a surgical intervention. A variety of filler materials are currently available and have been used for facial soft tissue augmentation. Of these, hyaluronic acid (HA) derivatives, calcium hydroxylapatite gel (CaHA), and silicone have most frequently been used for treating nasal deformities. While effective, silicone is known to cause severe granulomatous reactions in some patients and should be avoided. HA and CaHA are likely safer, but still may occasionally lead to complications such as infection, thinning of the skin envelope, and necrosis. Nasal injection technique must include sub-SMAS placement to eliminate visible or palpable nodularity. Restricting the use of fillers to the nasal dorsum and sidewalls minimizes complications because more adverse events occur after injections to the nasal tip and alae. We believe that HA and CaHA are acceptable for the treatment of postrhinoplasty deformities in carefully selected patients; however, patients who are treated must be followed closely for complications. The use of any soft tissue filler in the nose should always be approached with great caution and with a thorough consideration of a patient's individual circumstances.

Nonsurgical management of a large necrotic nasal tip wound using a viable cryopreserved placental membrane

“…The use of other biomaterials like bovine cross‐linked collagen dermal substitute (BCDS, Integra®, Integra LifeSciences Corp., Plainsboro, NJ) or soft tissue fillers (collagen, hyaluronic acid, etc) as an alternative to the forehead flap for the nasal tip reconstruction has been reported in the literature 15, 16, 17, 18. The use of soft tissue fillers injections be performed after reconstructive procedures, but such injections are more appropriate for nasal dorsum and sidewalls to minimize potential complications such as infection, inflammation, and tissue necrosis 18.…”

“…The use of soft tissue fillers injections be performed after reconstructive procedures, but such injections are more appropriate for nasal dorsum and sidewalls to minimize potential complications such as infection, inflammation, and tissue necrosis 18. The BCDS requires two surgical procedures: its grafting followed by a skin autograft three‐four weeks later 15, 16, 17.…”

Hyaluronic acid used for the correction of nasal deviation in an 18-year-old Middle Eastern man

“…The main indications are correction of remaining asymmetries and contour irregularities in the postoperative rhinoplasty patient (2,4). Although the number of reports of fillers used for primary rhinoplasty are few, a small number of surgeons have recently described excellent outcomes in selected patients using this method (1,3,5).…”

“…Soft tissue filler injection has been adopted by several surgeons as a method of correcting deformities of the nose (1)(2)(3)(4)(5). The main indications are correction of remaining asymmetries and contour irregularities in the postoperative rhinoplasty patient (2,4).…”

“…The excellent outcomes with filler materials has led to its current surge in popularity in North America. In addition to using filler countouring for standard procedures, plastic surgeons and dermatologists have begun to consider new uses for soft tissue fillers (1)(2)(3)(4)(5).…”