Journal archive · Non-surgical and filler rhinoplasty · Complications and management · Anatomy and nasal analysis · 2016
Global Aesthetics Consensus: Avoidance and Management of Complications from Hyaluronic Acid Fillers-Evidence- and Opinion-Based Review and Consensus Recommendations
Signorini M, Liew S, Sundaram H, De Boulle KL, Goodman GJ, Monheit G, Wu Y, Trindade de Almeida AR, Swift A, Vieira Braz A.
In the archive as a landmark paper: the core sweep runs 2011–2026, and this one is here because the history of rhinoplasty rests on it · cited on filler complications.
Abstract
Background: Although the safety profile of hyaluronic acid fillers is favorable, adverse reactions can occur. Clinicians and patients can benefit from ongoing guidance on adverse reactions to hyaluronic acid fillers and their management.
Methods: A multinational, multidisciplinary group of experts in cosmetic medicine convened the Global Aesthetics Consensus Group to review the properties and clinical uses of Hylacross and Vycross hyaluronic acid products and develop updated consensus recommendations for early and late complications associated with hyaluronic acid fillers.
Results: The consensus panel provided specific recommendations focusing on early and late complications of hyaluronic acid fillers and their management. The impact of patient-, product-, and technique-related factors on such reactions was described. Most of these were noted to be mild and transient. Serious adverse events are rare. Early adverse reactions to hyaluronic acid fillers include vascular infarction and compromise; inflammatory reactions; injection-related events; and inappropriate placement of filler material. Among late reactions are nodules, granulomas, and skin discoloration. Most adverse events can be avoided with proper planning and technique. Detailed understanding of facial anatomy, proper patient and product selection, and appropriate technique can further reduce the risks. Should adverse reactions occur, the clinician must be prepared and have tools available for effective treatment.
Conclusions: Adverse reactions with hyaluronic acid fillers are uncommon. Clinicians should take steps to further reduce the risk and be prepared to treat any complications that arise.
Abstract as indexed by PubMed; the article is open access (PubMed Central).
Citation
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Non-surgical and filler rhinoplasty
Injecting hyaluronic acid into the nose takes fifteen minutes, satisfies almost everyone who has it, lasts eight to fourteen months, and carries one risk that no amount of satisfaction offsets: filler entering an artery, which in 22 published cases took the patient's sight and gave it back to only 27% of them.
Complications and management
Serious complications after rhinoplasty are rare: infection runs under 1% in the two largest single-surgeon series, pooled rib harvests record no pneumothorax, and the bleeding series record no thromboembolism.
Anatomy and nasal analysis
Before any technique is chosen, the nose has to be read: the bone measured, the cartilage counted, the skin assessed, and the result the patient wants agreed on a photograph that is not yet true.
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