The injectable filler in rhinoplasty: not a complication-free alternative.

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The injectable filler in rhinoplasty: not a complication-free alternative.

PROBLEM

Non-surgical or "filler" rhinoplasty seems an attractive tool to fine-tune the aesthetic results of surgery; its use as a primary technique is also increasingly popular. However, physicians performing these procedures should be aware that they are not complication-free.

METHODOLOGY/RESULTS: In two case studies we now describe potential foreign body reactions, resulting in granulomas, to first generation silicone oil fillers, and second generation injectable hyaluronic acid fillers.

CONCLUSIONS

Foreign body reactions are especially prevalent against permanent fillers, particularly silicone, and ideally these should be abandoned. Given that granulomas can also be provoked by temporary and semi-permanent fillers, we would advise restraint in their use, with appropriate vigilance to ensure the early recognition of complications. The increasing popularity of filler rhinoplasty will likely provoke a higher incidence of complications in the future. Intralesional steroid injections can be attempted as a treatment, although surgical resection of these "granulomas" may ultimately be required.