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Asociación Colombiana de Otorrinolaringología y Cirugía de Cabeza y cuello, Maxilofacial y Estética Facial (ACORL)

2022, Number 4

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Acta de Otorrinolaringología CCC 2022; 50 (4)

Surgical Management of Biopolymers in Nasal Tip: Case Report and Literature Review

Thomas LS, González C, Heredia N

Language: Spanish
References: 15
Page: 304-308
PDF size: 206.10 Kb.


ABSTRACT

Introduction: Injectable facial fillers have been widely used worldwide. There are temporary, semipermanent, and permanent fillers. Regarding permanent fillers silicone is the most widely used, approved by the Food and Drug Administration (FDA) in two presentations Adatosil and Silicon 100 for retinal detachment. In 1997 the FDA allows for the off-label use prescribed within the doctor-patient relationship. There have been reported multiple adverse events, mainly inflammatory symptoms, foreign body reactions, sepsis, and product migration generally occurring by inappropriate application by untrained personnel. Case report: We present the case of a male patient in the fifth decade of life who underwent the application of silicone oil at the level of the nasal tip, and later presented secondary dermatopathy without response to medical management, which requires surgical management to remove the allogeneic material and secondary nasal reconstruction. Discussion: Facial fillers have been widely used, however, the use of liquid silicone for rhino modeling can bring adverse events such as inflammation, granulomatous reaction, necrosis, and ulcers secondary to the use of impure silicone and performed by untrained personnel. The treatment of silicone granulomas is based mainly on case reports. The first line of treatment is intralesional infiltrations, additionally pharmacological management, such as tacrolimus, etanercept, isotretinoin, and allopurinol. As a second line of treatment, there is surgery to remove the foreign body and nasal reconstruction to preserve the functional and aesthetic integrity of the nose. Conclusion: The use of silicone for rhinoplasty is not a safe technique and leads to documented adverse events. These occur mainly due to the use of impure silicone, and an inadequate technique by untrained personnel.


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