Complications of Nonsurgical Rhinoplasty with Hyaluronic Acid Injections: A Narrative Review

IF 2.8 3区医学 Q2 SURGERY Aesthetic Plastic Surgery Pub Date : 2025-01-02 DOI:10.1007/s00266-024-04636-4

Alberto Caranti, Radulesco Thomas, Fabio Facchini, Ruggero Campisi, Chiara Bianchini, Stefano Pelucchi, Andrea Ciorba, Gianicola Iannella, Antonino Maniaci, Justin Michel, Claudio Vicini

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Abstract

Background

The increasing popularity of cosmetic procedures has led to a rise in both surgical and nonsurgical interventions. Rhinoplasty, particularly nonsurgical rhinoplasty using injectable fillers such as hyaluronic acid (HA), has become highly sought after due to its minimally invasive nature. Despite its benefits, complications can occur, ranging from minor to severe.

Methods

This narrative review adheres to PRISMA guidelines and evaluates the complications associated with injectable rhinofillers. A comprehensive search was conducted in PubMed and Embase databases for articles published between January 1, 1990, and September 30, 2023, using specific keywords related to nonsurgical rhinoplasty and its complications. A total of 180 articles were identified, with 80 included in the final review.

Results

Complications from injectable rhinofillers vary widely. Common early-onset issues include asymmetry, injection site reactions, and hypersensitivity. Severe complications like vascular occlusion can lead to tissue ischemia, necrosis, or even blindness. Infection, Tyndall effect, nodules, granulomas, scarring, and biofilms are also documented. The incidence of severe complications is relatively low but requires immediate and effective management to prevent long-term consequences.

Conclusions

Nonsurgical rhinoplasty using fillers, particularly HA, is generally safe with a low risk of severe complications. Awareness and prompt management of potential complications are crucial for practitioners. Preventative measures, precise techniques, and thorough anatomical knowledge can mitigate risks, ensuring better patient outcomes.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

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注射透明质酸的非手术鼻成形术的并发症：一个叙述性的回顾。

背景：整容手术的日益普及导致了手术和非手术干预的增加。鼻整形术，特别是使用透明质酸（HA）等可注射填充物的非手术鼻整形术，由于其微创性而受到高度追捧。尽管它有好处，但也会发生从轻微到严重的并发症。方法：本综述遵循PRISMA指南，评估注射鼻填充物相关的并发症。我们在PubMed和Embase数据库中对1990年1月1日至2023年9月30日期间发表的文章进行了全面的检索，使用与非手术鼻整形术及其并发症相关的特定关键词。共确定了180篇文章，其中80篇纳入最终审稿。结果：注射鼻填充物的并发症多种多样。常见的早发性疾病包括不对称、注射部位反应和过敏。严重的并发症如血管闭塞可导致组织缺血、坏死，甚至失明。感染、廷德尔效应、结节、肉芽肿、疤痕和生物膜也有记录。严重并发症的发生率相对较低，但需要立即和有效的管理，以防止长期后果。结论：非手术鼻整形使用填充物，特别是HA，通常是安全的，严重并发症的风险低。意识和及时管理潜在的并发症是至关重要的从业人员。预防措施、精确的技术和全面的解剖学知识可以降低风险，确保更好的患者预后。证据等级iv：本刊要求作者为每篇文章指定一个证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者说明www.springer.com/00266。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Aesthetic Plastic Surgery 医学-外科

CiteScore

4.40

自引率

25.00%

发文量

479

审稿时长

3 months

期刊介绍： Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP). Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships. Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.