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Filler injection rhinoplasty

Fillers can enhance shallow contours, soften facial creases and wrinkles and can improve the appearance of recessed scars.

Non-surgical rejuvenation injection rhinoplasty with soft tissue fillers, may achieve similar results as surgery in certain selected patients. 

We only use resorbable fillers, especially in this indication. There are many kinds of resorbable fillers and each one lasts different lengths of time. Slowly, your body absorbs the filler, this metabolism depends on each individual.

Hyaluronic acid (Restylane, Juvederm, Belotero). Hyaluronic acid draws fluid to the treated area.The effect lasts about 9 to 18 months depending on the location and the product.
Fat cells harvested from your body (autologous fat). The effect can last for months to years.
A treatment session takes about 15 to 45 minutes.

 

A second session may be required for injection rhinoplasty. Some fillers are done in repeat sessions a couple of weeks apart.

After Treatment you may expect:
some pain, redness, swelling, and possibly itching, swelling may last up to 36 hours.

If symptoms start to get worse 1 to 3 days after the treatment, call your doctor-you may be getting an infection.

Each syringe of filler costs several hundreds of CHF. Costs vary, depending on the type of filler. 

Patients should apply ice to the injected area after the treatment.

Neuromodulation (botulinum toxin)

Dynamic nasal muscle treatment

Many muscles affect the nose, especially the position of the nasal tip and the function of the nasal valves. Use of botulinum toxin may help shape the nose in certain indications. 

Contra-indications and potential secondary effects of botulinum toxin will be discussed during the consultation. 

​Botulinum toxin is a very safe and effective treatment for expression lines. It can also change the skin, decrease muscle mass due to less activity and help shape the brow.

 

The procedure takes approximately five to ten minutes. The treatment is temporary and lasts anywhere between 2 to 6 months.

Risks of injections

Risks of Hyaluronic Acid Injections

Filler injection can lead to problems. Possible complications include:

  • Infection (new redness, swelling, or pain after the first day. You may need antibiotics right away)

  • Bleeding or bruising. Before a filler injection, avoid alcohol use and stop taking any blood-thinning medicine. This includes aspirin, any other type of nonsteroidal anti-inflammatory drug (NSAID), or vitamin E

  • Allergic reaction, such as rash, hives, swelling, or flu-like symptoms

  • Lumpy skin surface after treatment

  • If you have a lot of herpes zoster or herpes simplex outbreaks, a filler injection could trigger a flare-up. If you have several herpes outbreaks a year, your doctor will want you to take an antiviral medicine before having a filler injection

  • There are rare reports of serious or life-threatening complications after filler injection, including anaphylactic shock, sepsis, blood clot in the retinal artery leading to blindness, skin breakdown (necrosis), and abscess needing drainage

  • Granulomatous foreign body reaction can develop months to years after the injection. This reaction may be asymptomatic or have associated erythema and swelling. Persistent granulomatous foreign body reactions can be treated with intralesional corticosteroid injections. One way use of hyalorunidase, hoping that the break-down of the product would stop the foreign body reaction

  • One angioedema-type reaction without airway involvement was reported after the injection of hyaluronic acid (Restylane) in a lip

 

The first step in minimizing unwanted results is to begin by injecting temporary fillers. This will enable both the patient and the treating physician to evaluate the cosmetic results and decide whether or not a more permanent filler would be desirable
Swelling and bruising can be minimised by avoiding the use of anticoagulant medication or over-the-counter products and applying ice-packs before and after a treatment along with gentle but firm pressure after a treatment
A thorough understanding of the different recommended depths for injecting different products is also mandatory to avoid the reactions associated with injections placed too superficially.

As a general rule, non-permanent, absorbable fillers can be injected more superficially and the more permanent fillers need to be injected more deeply.

Exaggerated and repeated movements should be minimised during the first 3 days after a treatment to minimise product migration/displacement

Narrow, deep and depressed scars as a result of varicella and acne (especially the ‘ice-pick’-type scars) are susceptible to a phenomenon called ‘doughnutting’ where the periphery of the scar elevates with the filler above the depressed or retracted centre of the scar

Contra-indications for injections

Contra-indications and CAVEATS

The major contraindications to the use of a filler are as follows:

pregnant women

active infection near the site of injection

a known allergy/hypersensitivity to the material or to the lidocaine mixed in the syringe of the filler

 

No causal relationship has been established between the use of filler and autoimmune diseases like dermatomyositis/polymyositis, lupus erythematosus, rheumatoid arthritis or scleroderma. Their use is therefore not contraindicated in patients suffering from those diseases.

Immunosuppression has not been found to increase the risk of complications linked to the use of fillers other than poly-L-lactic acid (Sculptra).

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