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

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.