Injection Rhinoplasty with Hyaluronic Acid and Calcium Hydroxyapatite: A Retrospective Survey Investigating Outcome and Complication Rates

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.

Use of injectables in rhinoplasty retouching: Towards an evolution of surgical strategy? Literature review

“…The study flow diagram is available (figure1). The included studies are listed in Table 1 [2][3][4][5][6][9][10][11]13,14,[16][17][18][19][20].…”

“…Beside surgical rhinoplasty, injections of fillers to correct nasal deformities are currently emerging and become more and more popular [8]. This emergence of injectables using may change our practices given their efficiency to correct some postoperative defects of rhinoplasties [3][4][5][6][9][10][11][12][13][14]. However, the iatrogenicity of injectable should not be underestimated and it is necessary to proceed with a rigorous technique to avoid complications, among which some may be serious [2,3,5,[9][10][11]14,15].…”

The Art of Camouflage: When Can a Revision Rhinoplasty Be Nonsurgical?

“…Injection into the dorsum and glabella caused CaHA emboli to the arterial ophthalmic system and resulted in partial ophthalmoplegia, occlusion of the retinal artery, and multiple choroidal emboli. Schuster 13 performed a comprehensive retrospective review of outcomes and complication rates using both HA and CaHA nasal injections for both primary and secondary rhinoplasty noses. He reported one moderate and two severe complications (infection and skin necrosis) using Radiesse and subsequently changed his technique to only using HA fillers for nasal injections.…”

Effect of surface microstructure on the anti‐fibrosis/adhesion of hydroxyapatite ceramics in spinal repair of rabbits

“…Especially, when optimized with appropriate macroporous and surface micro/nano structure, HA could have good osteoinductivity . Except for hard tissue repair or substitution, HA can be used as ocular prosthesis and soft tissue filler, presenting good soft tissue compatibility . It is known that natural vertebral lamina has complex anatomical structure with multiple tissue interfaces.…”