Removing nasal filler is often required due to diverse reasons. Acute side effects such as blindness, skin necrosis, infecton are representative reasons. Recurrent skin reaction, nodule or granulation formation, and pressure sense are other reasons for filler removal. Hyaluronic acid filler is easily removed with hyaluronidase injection. Non-resorbable fillers such as auqamid can be squeezed out after making a small incision on the skin, but sometimes it is difficult to completely remove all the fillers injected into the dermis. Trying to attempt all the fillers has the danger of damaging dermis. Sometimes open approach is required when simultanous rhinplasty after filler removal is required. At least a week prior to surgery, absorbable fillers are removed with hyaluronidase injection for accurate shape control in revision rhinoplasty. Fillers at the nasal tip can be removed at the time of open approach and you can often observe inflammation of the soft tissue around the tip.
This lady in below photos had nasal deviation, hump nose, and tip ptosis with breathing difficulty. Septum was corrected first, and this made the lower 2/3 of the nose straight. Hump was not resected but rasped with Piezotome and this did not breach the keystone area, which made spreader grafts unnecessary.Bilateral osteotomies with Piezotome made her bone straight. Together with septum correction and effective osteotomies, her nose became straight from the frontal view. Tip was modified with sutures and onlay graft only. No strut or septal extension graft was used and this made the tip soft even after considerable amount of rotation and projection increase. Radix was augmented with bruised cartilage. Overall, she could breath much better after surgery and her nose became more harmonious and feminine.
المعلومات التي شاركتها هنا مفيدة حقًا مثل أفضل المراكز الإيرانية لعملية تجميل الأنف تحتوي على بعض المعرفة العظيمة التي مفيد جدا بالنسبة لي. شكرا لنشره. أبقه مرتفعا.
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