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Managing patients with prior facial fillers before rhinoplasty lacks consensus. Many surgeons are unaware of filler complications, highlighting the need for clear management guidelines for this growing patient group.

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Area of Science:

  • Plastic Surgery
  • Facial Plastic Surgery
  • Otolaryngology

Background:

  • Nonsurgical rhinoplasty using facial fillers is increasingly common.
  • Managing patients with prior filler injections presents unique challenges for rhinoplasty surgeons.

Purpose of the Study:

  • To investigate current management strategies employed by rhinoplasty surgeons for patients with previous nonsurgical rhinoplasty and facial fillers.
  • To identify variations in surgical approaches and preoperative management.

Main Methods:

  • A multicenter international cross-sectional study adhering to STROBE guidelines.
  • A survey distributed to members of the European Academy of Facial Plastic Surgery and associated colleagues.
  • Analysis of responses from 165 surgeons across 45 countries meeting inclusion criteria.

Main Results:

  • 74% of surgeons operate on patients with prior nasal fillers, with a mean waiting period of 21 weeks.
  • 44% remove fillers preoperatively (primarily with hyaluronidase), and 76% remove them intraoperatively.
  • 25% of surgeons modify surgical steps for patients with a history of fillers, indicating a lack of standardized approach.

Conclusions:

  • There is a significant lack of consensus among rhinoplasty surgeons regarding the management of patients with prior nasal fillers.
  • Surgeons often lack awareness of preoperative filler existence, potential complications, and standardized management protocols.
  • Establishment of clear guidelines is crucial to manage the increasing number of patients seeking rhinoplasty after facial filler treatments.