An Italian Online Survey Regarding the Use of Hyaluronidase in Previously Hyaluronic Acid-Injected Noses Looking for Surgical Rhinoplasty

Samuel Staglianò; Gianpaolo Tartaro; Dario Bertossi; Michele Pascali; Valerio Finocchi; Nicola Zerbinati; Pierfrancesco Bove; Pierfrancesco Cirillo; Romolo Fragola; Raffaele Rauso

doi:10.1093/asjof/ojac060

An Italian Online Survey Regarding the Use of Hyaluronidase in Previously Hyaluronic Acid-Injected Noses Looking for Surgical Rhinoplasty

Aesthet Surg J Open Forum. 2022 Jul 4:4:ojac060. doi: 10.1093/asjof/ojac060. eCollection 2022.

Authors

Samuel Staglianò¹, Gianpaolo Tartaro¹, Dario Bertossi², Michele Pascali, Valerio Finocchi, Nicola Zerbinati³, Pierfrancesco Bove, Pierfrancesco Cirillo, Romolo Fragola¹, Raffaele Rauso¹

Affiliations

¹ Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
² Maxillofacial Surgery Department, Department of Oral and Maxillofacial Surgery, University of Verona, Verona, Italy.
³ Dermatology Department, University of Insubria, Varese, Italy.

Abstract

Background: Nonsurgical nasal reshaping (nSNR) with hyaluronic acid (HA) filler is a well-established procedure performed to ameliorate nasal appearance and is considered a valid alternative to surgical rhinoplasty in selected patients.

Objectives: The aim of our study is to evaluate the decision-making process and management of patients undergoing rhinoplasty, with previous HA filler injection, and evaluate if consensus could be achieved to recommend guidelines.

Methods: Between April and May 2021, an online survey was sent to 402 Italian surgeons of different specialties. The survey collected information regarding the types of treatment of patients who have previously undergone nSNR, who should undergo surgical rhinoplasty. For those surgeons using hyaluronidase, an additional information was collected.

Results: In a range of time of 2 months (April and May 2021), a total of 72 surgeons replied and completed the survey: out of the 402 questionnaires sent, the response rate was approximately 18%. The majority of respondents (61.5%) replied to inject hyaluronidase (HYAL) in patients who had to undergo a rhinoplasty but reported previous nSNR. Of the surgeons who use HYAL, 70% performed rhinoplasty after a waiting time of 3 to 4 weeks.

Conclusions: Either direct surgical approach or hyaluronidase injection first seems to be a viable options. The use of HYAL before surgery is the choice with the broadest consensus in our survey. However, a larger case-control study with long follow-ups is necessary to understand if in patient seeking surgical rhinoplasty who already received nSNR, the injection of hyaluronidase before surgery is mandatory, recommended, or not.