Facial Plast Surg
DOI: 10.1055/a-2541-2508
Original Research

Nonsurgical Rhinoplasty: Histopathological Effects of Dermal Fillers on Nasal Cartilage in a Rabbit Model

1   Department of Otorhinolaryngology & Head and Neck Surgery, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye
,
1   Department of Otorhinolaryngology & Head and Neck Surgery, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye
,
1   Department of Otorhinolaryngology & Head and Neck Surgery, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye
,
2   Department of Pathology, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Türkiye
,
3   İstanbul Experimental Research, Development and Education Center (İDEA), Mehmet Akif Ersoy Training and Research Hospital, İstanbul, Türkiye
,
1   Department of Otorhinolaryngology & Head and Neck Surgery, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye
,
1   Department of Otorhinolaryngology & Head and Neck Surgery, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye
› Author Affiliations

Abstract

Nonsurgical rhinoplasty has emerged as a preferred nasal aesthetic treatment due to its safety, predictability, and high patient satisfaction. It utilizes dermal fillers, primarily hyaluronic acid (HA), to enhance nasal profiles and correct defects. However, limited data exist on the effects of HA-containing dermal fillers on nasal cartilage. This study aimed to evaluate these effects histopathologically. Sixteen New Zealand white rabbits were divided into two groups (A and B). Group A's right lateral cartilages (AR) received 0.1 mL of VYC-20L filler, while the left (AL) received isotonic saline. Group B's right lateral cartilages (BR) received 0.1 mL of VYC-25L filler, with the left (BL) serving as the control. After 90 days, the rabbits were sacrificed, and cartilage samples were analyzed histopathologically for cartilage thickness, chondrocyte nucleus loss, inflammation, fibrosis, giant cells, granulation tissue, abscess, and necrosis. Statistical significance was set at p < 0.05. Significant differences were found between groups for chondrocyte nucleus loss, fibrosis, and giant cells (p = 0.005, 0.018, <0.001, respectively). No difference was observed in cartilage thickness between AR and BR (p = 0.918). Chondrocyte nucleus loss was present in AR and BR but absent in AL and BL. Giant cells were detected in all VYC-20L and VYC-25L samples. Chronic inflammation and fibrosis varied but were not statistically significant. No abscess or necrosis was observed. This study demonstrated the histopathological effects of VYC-20L and VYC-25L on nasal cartilage using a rabbit model. Further studies with larger samples and diverse fillers are recommended.

Ethical Approval

This study was conducted at the Bakırköy Dr. Sadi Konuk Training and Research Hospital's Department of Otorhinolaryngology & Head and Neck Surgery. It adhered to the ethical principles of the Declaration of Helsinki and the Good Laboratory Practices Guide for animal studies. Ethical approval was obtained from the İstanbul Mehmet Akif Ersoy Training and Research Hospital Animal Experiments Local Ethics Committee (reference number 2023/07).




Publication History

Accepted Manuscript online:
18 February 2025

Article published online:
27 February 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Bertossi D, Magagnotto N, Chirumbolo S, D'Souza A, Nocini R. Nonsurgical rhinoplasty: long-term follow-up of high G′ HA nasal injections. Facial Plast Surg 2022; 38 (02) 96-101
  • 2 Song D, Wang X, Yu Z. Nonsurgical rhinoplasty: an updated systematic review of technique, outcomes, complications, and its treatments. Aesthetic Plast Surg 2024; 48 (23) 4902-4915
  • 3 Humphrey CD, Arkins JP, Dayan SH. Soft tissue fillers in the nose. Aesthet Surg J 2009; 29 (06) 477-484
  • 4 Webster RC, Hamdan US, Gaunt JM, Fuleihan NS, Smith RC. Rhinoplastic revisions with injectable silicone. Arch Otolaryngol Head Neck Surg 1986; 112 (03) 269-276
  • 5 Ramos HHA, Freire L, Cavallieri F, Frota AE, Ragazzo R, Jurado JRP. Management of patients seeking surgical rhinoplasty with previous nasal injections of hyaluronic acid. Aesthetic Plast Surg 2021; 45 (04) 1675-1682
  • 6 Bertossi D, Lanaro L, Dorelan S, Johanssen K, Nocini P. Nonsurgical rhinoplasty: nasal grid analysis and nasal injecting protocol. Plast Reconstr Surg 2019; 143 (02) 428-439
  • 7 Hedén P. Nasal reshaping with hyaluronic acid: an alternative or complement to surgery. Plast Reconstr Surg Glob Open 2016; 4 (11) e1120
  • 8 Azizli E, Alkan Z, Bekem A. et al. Biomechanical and histological features of costal cartilage graft in a rabbit model: comparative results with three months of follow-up. KBB-Forum 2021; 20: 106-114
  • 9 Beasley KL, Weiss MA, Weiss RA. Hyaluronic acid fillers: a comprehensive review. Facial Plast Surg 2009; 25 (02) 86-94
  • 10 Qiao J, Jia QN, Jin HZ. et al. Long-term follow-up of longevity and diffusion pattern of hyaluronic acid in nasolabial fold correction through high-frequency ultrasound. Plast Reconstr Surg 2019; 144 (02) 189e-196e
  • 11 Abboud L, Souissi A, Boucher F, Weill E, Mojallal A. Surgical rhinoplasty after prior hyaluronic acid based nose remodeling. Ann Chir Plast Esthet 2024; 69 (01) 17-26
  • 12 Ale de Souza MM, Gregório LC, Sesso R, Souza SA, Settanni F. Study of rabbit septal cartilage grafts placed on the nasal dorsum. Arch Facial Plast Surg 2008; 10 (04) 250-254
  • 13 Kazikdas KC, Ergur B, Tugyan K, Guneli E, Kaya D, Sahan M. Viability of crushed and diced cartilage grafts wrapped in oxidized regenerated cellulose and esterified hyaluronic acid: an experimental study. Laryngoscope 2007; 117 (10) 1728-1734
  • 14 Herrmann JL, Hoffmann RK, Ward CE, Schulman JM, Grekin RC. Biochemistry, physiology, and tissue interactions of contemporary biodegradable injectable dermal fillers. Dermatol Surg 2018; 44 (Suppl. 01) S19-S31
  • 15 Wollina U, Goldman A. Filler migration after facial injection—a narrative review. Cosmetics 2023; 10 (04) 115
  • 16 Chae SY, Lee KC, Jang YH, Lee SJ, Kim DW, Lee WJ. A case of the migration of hyaluronic acid filler from nose to forehead occurring as two sequential soft lumps. Ann Dermatol 2016; 28 (05) 645-647