Facial Fillers and Surgical Rhinoplasty: Cross-Sectional Study

Overview

The European Academy of Facial Plastic Surgery's filler working group distributed a STROBE-compliant survey to members and colleagues doing more than 10 rhinoplasties a year, to learn how surgeons handle patients with previous nasal or facial filler.

Sections of note

• 171 responses; 165 met inclusion; ENT 41%, facial plastic 23%, maxillofacial 10%, plastic 7%.
• Respondents averaged 116 rhinoplasties per year and 13 years of experience.
• 74% operate on patients with prior nasal filler; typical wait 21 weeks after filler.
• 44% remove filler preoperatively, mainly with hyaluronidase; 76% remove it intraoperatively; 25% change their surgical steps.
• Surgeons were often unaware of existing fillers and their complications; the authors call for guidelines.

What it means for a patient

• If you have had nasal filler and want surgery, expect a wait of several months and possibly a dissolving injection first.
• Practices vary widely between surgeons, so ask what your surgeon does and why.
• Disclose all filler history; the survey suggests surgeons often do not know it is there.

Why this paper matters

It documents the absence of a standard approach to a common situation among high-volume surgeons. Limits: self-reported practice, no outcomes, response rate not stated.

Terms

• Hyaluronidase: an enzyme injection that dissolves hyaluronic acid filler.
• Cross-sectional study: a snapshot survey at one point in time.
• STROBE: reporting guidelines for observational studies.
• European Academy of Facial Plastic Surgery (EAFPS): the European specialty society.