Susan Mayou

Articles

Managing rare complications from non-surgical rhinoplasty

It is not uncommon for the Cadogan Clinic’s team of experts to be called upon to help manage complications arising from procedures carried out at other clinics.

Tagged: Facial Treatments

It is not uncommon for the Cadogan Clinic’s team of experts to be called upon to help manage complications arising from procedures carried out at other clinics.

Mr Dominic Yue, a consultant plastic surgeon operating here at the clinic, was recently contacted about a patient who was experiencing a rare but severe complication from a non-surgical rhinoplasty (nose job).

The 32-year-old man had the procedure at another clinic in a bid to straighten the bridge of his nose and improve the appearance of his nasal tip. A cannula was used to inject dermal filler directly into the tip of the nose.

The following day, the man experienced pain and noticed a change in skin colour in the treatment area. This progressed and the man showed early signs of blocked blood vessels, a rare but severe complication of non-surgical rhinoplasty.

The clinic injected two doses of hyaluronidase in a bid to break down the dermal filler before seeking a second opinion from Mr Yue as to how to manage the complication.

Speaking in an interview in this month’s Aesthetics Journal, Mr Yue said: “As no other therapy had been started, I advised him to take 300mg of aspirin (continuing with 75mg for a week thereafter) and 30mg of prednisolone for three days to reduce swelling that had already started.”

By day two post-procedure, the distribution of skin colour changes increased and the rims of the man’s upper and lower eyelid had turned purple.

There was also evidence of erythema, a type of skin rash caused by inflamed blood capillaries, along the man’s right brow and some of his eyelashes had fallen out.


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Mr Yue said: “As the discolouration extended, I reinjected more hyaluronidase as microdoses to

spread evenly across this extended area.

“It is worth noting that his previous brow filler, which lay within the distribution, also dissipated.

“Gentle warm compresses and massages were performed to help disperse the drug and encourage vasodilation (widening of the blood vessels).

“He was asked to commence on vitamin C and zinc supplementation to maximise healing.

“I advised on basic skincare to keep the area clean with gentle cleansing, light moisturisation and sun protection.”

The area of discolouration stopped spreading on day three, but continued to darken for another couple of days and pustules started to form on the man’s skin.

Much to his relief, the discolouration and inflammation started to improve on day five and the final pustule had dried out by day 10. After two weeks there were no pustules, scabs or inflammation.

Mr Yue said: “I advised him to start a vitamin C serum, niacinamide serum and to continue with sun protection to minimise hyperpigmentation.

“At four weeks, there was only faint erythema at the nasal bridge with a slightly depressed scar.

“By six weeks, all discolouration had resolved, but the depressed scar was visible.

“By three months, the depressed scar was almost imperceptible.”

Despite his experience, the man was keen to have another treatment, but was advised that he should wait.

Six months later the man returned for another non-surgical rhinoplasty, this time with Mr Yue and without complications.

A cold pack was used before and after the procedure to constrict the blood vessels and reduce the risk of inflammation.

When caught early, blocked blood vessels can be treated, but if the condition progresses and is left untreated, it can cause scarring, pigmentation, asymmetry and tissue death (necrosis).

Mr Yue added: “Having knowledge of the anatomy around the nose is essential prior to performing injections in the area.”

All the consultants operating at the Cadogan Clinic are experts in their field. This means it is highly unlikely for complications to occur in the first place. But rest assured that if any complications were to occur, then you are in the best possible hands here at our award-winning London clinic.

Words from our clients:



Treatments mentioned in this article

Non-surgical rhinoplasty is a safe, non-invasive alternative to traditional rhinoplasty. Sometimes called the '15 minute nose job' as a quick treatment of dermal filler is all that is needed to reshape the nose completely.

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