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Nikparto N, Yari A, Mehraban SH, Bigdelou M, Asadi A, Darehdor AA, Nezaminia S, Khani M, Hakim LK, Eskandari F, Erfani M, Tebyaniyan H. The current techniques in dorsal augmentation rhinoplasty: a comprehensive review. Maxillofac Plast Reconstr Surg 2024; 46:16. [PMID: 38678507 PMCID: PMC11056355 DOI: 10.1186/s40902-024-00418-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/13/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND An essential aspect of rhinoplasty is the enhancement of the nasal dorsal contour by performing dorsal augmentation (DA) rhinoplasty. A wide range of techniques are available for DA as the demand for aesthetic nasal refinement grows. This review aims to provide a comprehensive overview of the current techniques used in DA rhinoplasty. MAIN BODY Research articles on DA rhinoplasty techniques were identified through a comprehensive literature search. Scopus, PubMed, and Web of Science were used as electronic databases. Each database was searched for articles published since its inception. DA rhinoplasty techniques were examined in this literature review. Methodological quality was assessed for the selected studies, and data was extracted to examine materials used, surgical approaches, and reported outcomes for each technique. Various DA methods, including autologous grafts and synthetic implants, are examined in-depth in this review. Comparing approaches can help better understand their respective advantages and limitations. CONCLUSION A wealth of techniques is available for DA rhinoplasty, each with advantages. Patients' nasal anatomy, desired outcomes, and potential risks must be considered by surgeons when determining their surgical approach. DA methods continue to evolve rapidly, creating a need for a thorough understanding of the current landscape to make informed decisions.
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Affiliation(s)
- Nariman Nikparto
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Amir Yari
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
| | - Saeed Hasani Mehraban
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Meysam Bigdelou
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Amirmohammad Arabi Darehdor
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Sayna Nezaminia
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Mehdi Khani
- Resident of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
| | | | - Fateme Eskandari
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Erfani
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran.
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Beneduce N, Botter C, Coiante E, Hersant B, Meningaud JP. The longevity of the nonsurgical rhinoplasty: A literature review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101319. [PMID: 36280110 DOI: 10.1016/j.jormas.2022.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Non-surgical rhinoplasty is one of the terms used to describe the technique of injecting fillers into the nasal pyramid region for aesthetic, and sometimes functional, purposes. Although it is now an extremely popular practice, the techniques proposed and the products used are different. This inhomogeneity is also found regarding the treatment longevity. METHOD A literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). It was realized to collect information on this disputed topic. Pubmed/MEDLINE database was explored. RESULTS A total of 228 articles were extracted from the basic literature search. 81 of these were excluded based on the content of the title and abstract. All 147 remaining articles were submitted for full-reading. 49 of these were excluded because the injection product used by the authors was not a hyaluronic acid based filler; while 82 of these were excluded because they provided no indication regarding the longevity of the treatment. Of the 16 selected studies, according to six authors, the duration of treatment is therefore between 8 and 12 months. For all the others, instead, the results seem to last longer than this period. The longest time interval was 8 years. DISCUSSION AND CONCLUSION Establishing with certainty the longevity of non-surgical rhinoplasty seemed to be extremely complex. In the light of this discordant data seems to be essential to deepen the argument. A study using imaging techniques and/or standardized photographic material appears essential to further investigate this controversial topic.
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Affiliation(s)
- Nicola Beneduce
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, Roma 00161, Italy; Department of Plastic, Reconstructive and Aesthetic Surgery and Maxillofacial Surgery, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - Charles Botter
- Department of Plastic, Reconstructive and Aesthetic Surgery and Maxillofacial Surgery, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France.
| | - Edoardo Coiante
- Department of Plastic, Reconstructive and Aesthetic Surgery and Maxillofacial Surgery, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - Barbara Hersant
- Department of Plastic, Reconstructive and Aesthetic Surgery and Maxillofacial Surgery, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - Jean-Paul Meningaud
- Department of Plastic, Reconstructive and Aesthetic Surgery and Maxillofacial Surgery, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
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Magacho-Vieira FN, Santana AP. Displacement of Hyaluronic Acid Dermal Filler Mimicking a Cutaneous Tumor: A Case Report. Clin Cosmet Investig Dermatol 2023; 16:197-201. [PMID: 36711075 PMCID: PMC9882410 DOI: 10.2147/ccid.s398014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/13/2023] [Indexed: 01/24/2023]
Abstract
There has been considerable growth in the number of cosmetic injectable procedures in recent years. Consequently, physicians in general are seeing a greater number of patients who have previously had cosmetic implants. These patients often fail to mention or do not admit to having had previous cosmetic procedures, conditions that should be noted in their medical histories. In this article, the authors report a rare case of hyaluronic acid filler displacement resulting from injection in the nasal radix region that had been administered 10 months prior, which the patient failed to mention. The filler migration mimicked facial tumors, entangling an otherwise easy case and it was only recognized with the use of dermatological ultrasound. This serves as a warning and a reminder to include complications from cosmetic procedures in diagnostic hypotheses. Physicians need to be vigilant, question their patients' medical histories, and be familiar with diagnostic imaging options. The presence of dermal fillers should always be considered in cutaneous tumor lesions, since they can last for months to years, or be present in locations distant from the site of application.
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Affiliation(s)
- Fabiano Nadson Magacho-Vieira
- Magacho Institute for Health Education, Fortaleza, CE, Brazil,Department of Clinical, Aesthetic and Surgical Dermatology, Batista Memorial Hospital, Fortaleza, CE, Brazil,Correspondence: Fabiano Nadson Magacho-Vieira, Clínica Magacho - Avenida Desembargador Moreira, 1300, Sala 1419 - Torre Norte, Fortaleza, CE, 60170-002, Brasil, Tel/Fax +55 85 3246 0829, Email
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Staglianò S, Tartaro G, Bertossi D, Pascali M, Finocchi V, Zerbinati N, Bove P, Cirillo P, Fragola R, Rauso R. An Italian Online Survey Regarding the Use of Hyaluronidase in Previously Hyaluronic Acid-Injected Noses Looking for Surgical Rhinoplasty. Aesthet Surg J Open Forum 2022; 4:ojac060. [PMID: 35903517 PMCID: PMC9317161 DOI: 10.1093/asjof/ojac060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Nonsurgical nasal reshaping (nSNR) with hyaluronic acid (HA) filler is a well-established procedure performed to ameliorate nasal appearance and is considered a valid alternative to surgical rhinoplasty in selected patients. Objectives The aim of our study is to evaluate the decision-making process and management of patients undergoing rhinoplasty, with previous HA filler injection, and evaluate if consensus could be achieved to recommend guidelines. Methods Between April and May 2021, an online survey was sent to 402 Italian surgeons of different specialties. The survey collected information regarding the types of treatment of patients who have previously undergone nSNR, who should undergo surgical rhinoplasty. For those surgeons using hyaluronidase, an additional information was collected. Results In a range of time of 2 months (April and May 2021), a total of 72 surgeons replied and completed the survey: out of the 402 questionnaires sent, the response rate was approximately 18%. The majority of respondents (61.5%) replied to inject hyaluronidase (HYAL) in patients who had to undergo a rhinoplasty but reported previous nSNR. Of the surgeons who use HYAL, 70% performed rhinoplasty after a waiting time of 3 to 4 weeks. Conclusions Either direct surgical approach or hyaluronidase injection first seems to be a viable options. The use of HYAL before surgery is the choice with the broadest consensus in our survey. However, a larger case-control study with long follow-ups is necessary to understand if in patient seeking surgical rhinoplasty who already received nSNR, the injection of hyaluronidase before surgery is mandatory, recommended, or not.
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Affiliation(s)
- Samuel Staglianò
- Corresponding Author: Dr Samuel Staglianò, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, Via Luigi De Crecchio, 6, 80138 Naples, Italy. E-mail:
| | - Gianpaolo Tartaro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Dario Bertossi
- Maxillofacial Surgery Department, Department of Oral and Maxillofacial Surgery, University of Verona, Verona, Italy
| | | | | | | | | | | | - Romolo Fragola
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Raffaele Rauso
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
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The Deep Columellar Approach for Liquid Rhinoplasty – A Case Series of 511 Procedures over 16 years. Facial Plast Surg Clin North Am 2022; 30:193-203. [DOI: 10.1016/j.fsc.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Alfertshofer MG, Frank K, Ehrl D, Freytag DL, Moellhoff N, Gotkin RH, Mardini S, Beleznay K, Swift A, Cotofana S. The Layered Anatomy of the Nose: An Ultrasound-Based Investigation. Aesthet Surg J 2022; 42:349-357. [PMID: 34363459 DOI: 10.1093/asj/sjab310] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND An increasing number of soft tissue filler procedures in the nasal region has been reported. Concomitant with demand, the number of complications has risen due to the difficulty in administering filler in a region where soft tissue layering is complex. OBJECTIVES The authors sought to describe the layered soft tissue arrangement of the nose as it relates to the underlying arterial vasculature and to define safer zones for nasal filler enhancement. METHODS A total of 60 (28 males and 32 females) study participants were investigated with respect to their layered anatomy in the midline of the nose utilizing ultrasound imaging. The presence and extent of the layered arrangement was examined as well as the depth of the arterial vasculature. RESULTS In the mid-nasal dorsum, a 5-layer arrangement was observed in 100% (n = 60) of all investigated cases, whereas it was found to be absent in the nasal radix and tip. The 5-layer arrangement showed an average extent of 26.7% to 67.5% in relation to nasal length. The nasal arteries coursed superficially in 91.7% of all cases in the nasal radix, in 80% in the mid-nasal dorsum, and in 98.3% in the nasal tip. CONCLUSIONS Soft tissue filler administration in the nose carries the highest risk for irreversible vision loss compared with any other facial region. The safety of soft tissue filler rhinoplasty procedures is enhanced by knowledge of the layered anatomy of the nose, the location and depth of the major nasal vasculature, and employment of maneuvers to decrease the risk of blindness.
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Affiliation(s)
- Michael G Alfertshofer
- Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - Konstantin Frank
- Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - Denis Ehrl
- Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - David L Freytag
- Department of Plastic Surgery, Community Hospital Havelhöhe, Berlin, Germany
| | - Nicholas Moellhoff
- Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University, Munich, Germany
| | | | - Samir Mardini
- Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA
| | - Katie Beleznay
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | | | - Sebastian Cotofana
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
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Hyaluronidase injection vs direct surgery in surgical rhinoplasty patients treated with non-surgical nasal reshaping with hyaluronic acid filler: a systematic review. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-021-01916-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Nonsurgical rhinoplasty is increasing in popularity, and when used appropriately, can be less costly and have less downtime than surgical rhinoplasty. It can offer patients a means of seeing how they would feel about a surgical rhinoplasty later. Injection can be safe but patients should still be counseled regarding the rare, possible risks of tissue loss and potentially irreversible tissue ischemia and irreversible blindness. Treatment with hyaluronidase can be partially effective when signs and symptoms are caught early; however, avoidance is still the best medicine along with seeking an experienced, qualified rhinoplasty plastic surgeon.
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