Effect of Facial Fillers on Post-rhinoplasty edema: A Hypothesis Based on Literature Review

Maamari SA, Vansteelant G, Appan S, D'Souza A.

What this paper says

A literature-based hypothesis paper proposing that hyaluronic acid facial fillers block or compress lymphatic drainage and so prolong swelling after rhinoplasty.

Overview

The senior author (D'Souza) observed that patients with facial fillers had persistent oedema after rhinoplasty. This narrative review gathers evidence on fillers and lymphatics to build a theory. There is no patient series; Level of Evidence IV.

Sections of note

Observation: patients with facial fillers experienced persistent post-rhinoplasty oedema.
Proposed mechanisms: hyaluronic acid's water-attracting nature, hardness, volume and "backflow phenomena."
Fillers may directly block or indirectly compress lymphatic pathways.
The authors call for objective measurement of filler effects on facial lymphatic drainage.

What it means for a patient

If you have had facial fillers, swelling after rhinoplasty may last longer; this is a hypothesis with clinical observation behind it, not a proven effect.
Tell your surgeon about any fillers, including in cheeks or under the eyes, not only in the nose.
No data on how much longer swelling lasts are given.

Why this paper matters

It raises a practical concern as filler use becomes near-universal among rhinoplasty candidates. Limits: hypothesis only, no measurements, single group's observation.

Terms

Oedema: swelling caused by fluid in the tissues.
Lymphatic drainage: the vessel network that clears fluid from tissues; disruption causes persistent swelling.
Hydrophilic: water-attracting, a property of hyaluronic acid that makes it swell.
Narrative review: a non-systematic summary of selected literature.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“The quest to achieve younger and media-driven facial aesthetics has resulted in an exponential increase in the use of facial fillers. Inevitably, this has meant that it is now commonplace for facial plastic surgeons to have patients with fillers in the face. In the senior author's experience (A.R.D.), it was observed…”

Excerpt; the full abstract is on PubMed.