Objectives: Addressing complications with hyaluronic acid dermal fillers after rhinoplasty. Highlighting liquid rhinoplasty as non-surgical global trend. Evaluating rare risks like blindness and necrosis, particularly in prior rhinoplasty. Introducing innovative filler technique used in 10,000+ cases, focusing on injection sequencing to maintain nasal profiles. Presenting outcomes of liquid rhinoplasty in prior surgery. Emphasizing technique's suitability for such cases.
Introduction: Nasal augmentation is a global trend, including our country. Liquid rhinoplasty offers a surgery-free solution for patients to address aesthetic concerns and resume their routine quickly. Despite rare complications, caution is exercised due to risks like blindness and necrosis, especially in patients with a rhinoplasty history.
Our new filler technique, used in 10,000 cases over 14 years, has notably lower complications in prior rhinoplasty patients. Among approximately 1,500 previous rhinoplasty cases, only 47 experienced minor complications using our method.
Materials / method: We present an application on a patient with a 3-year-old rhinoplasty. Initial filler (0.1 cc) was administered to the columellar area, followed by a 0.05 cc injection to the supratip. Avoiding over 0.1 cc in the tip-supratip is vital to prevent compression issues. Addressing cartilage collapses post-rhinoplasty, a microdroplet technique with 0.1 cc was applied at six points. In the radix, 0.05 cc achieved a better angle, totaling 0.35 cc.
Results: Blindness from fillers is rare; necrosis is more common due to arterial issues. Treating embolization is challenging, while circulation issues due to compression are relieved by removing it.
During rhinoplasty, neovascularization results in thinner yet branched vessels, reducing embolization risks. However, thinner vessels are more susceptible to compression. Minimizing compression risks involves releasing compressed filler, applying hyaluronidase, and gentle massaging.
Conclusion: In summary, contrary to what was assumed previously, the decrease in complication rates in patients with previous rhinoplasty is attributed to this mechanism. Intra-arterial embolization risks decrease, and in cases of compression, rapid diagnosis and treatment have been observed to lead to lower complication rates. This technique can readily be applied to patients who have previously undergone rhinoplasty.
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