Arleth
Chavez Velasco
Ciudad de Mexico
CELLULITE IN UN PAZIENTE DOPO POSIZIONAMENTO DI FILI TENSORIALI
INTRODUCTION The use of threads in aesthetic medicine has been used since 1956, when Butkewitz introduced a method to correct nasolabial folds using nylon threads. Despite the passage of time, there are not many publications in this regard, although those that do refer to short series of patients and do not agree with the scientific evidence on its efficacy or safety, mostly made with non-woven thread. In general, the results of rhinoplasty are generally very satisfactory, natural and immediate, although they do not last forever. After outpatient hyaluronic acid intervention, there is the possibility of complications and negative side effects in the short, medium and long term. Polydioxane (PDO) polydioxanone monofilament sutures, an absorbable material commonly used in surgical procedures. This effect arises both from the self-filling of the area through the placement of multiple threads and from the biological effects that are basically generated by the guidance of the collagen I and III threads and the reaction of the fibroblasts around the threads, resulting in the swabs It is considered that being threads inserted in atraumatic needles, makes the technique much easier and less painful. METHODOLOGY Case report of a 23-year-old female patient with no morbid history or previous surgeries. History of placement of tension threads in November 2022. He went to the otolaryngology service in January 2023, reporting pain and inability to breathe as well as persistent headache, referring to a sensation of nasal obstruction. On examination, a bulbous tip was observed, symmetrical nostrils, a hard mass was palpable that caused pain on palpation. Upon inspection, a tensor thread was observed at the tip of the nose, as well as edema and increased temperature at the site. When pulling it, there was no discharge of purulent material, however, the patient reported intense pain. Laboratory and imaging studies are requested with evidence of cellulite as well as data of allergic reaction to the placement of threads, laboratory studies with leukocytosis. It was decided to perform open rhinoseptoplasty in which a large amount of granulation tissue was found, material was removed from the tensing threads at the nasal tip and dorsum, which forced a change in the surgical plan since the patient presented cartilage necrosis, which is why it was I perform reconstruction of the cartilage of the nose with autologous auricular concha graft At the post-surgical evaluation, the patient evolved satisfactorily aesthetically and functionally. At 6 months the patient continues with adequate evolution, however, filling was performed on the tip of the nose since after the surgical procedure the patient presented sinking of the tip at the site where the tensing threads had been introduced. DISCUSSION Despite the safety of the treatment and its positive results, side effects can arise after the intervention, in most cases, the related complications can arise shortly after the procedure. Although extensive research has shown the safety and efficacy of thread lifting to improve the appearance of the face, this conclusion is not fully supported for nose reshaping. Additional research is needed to gain a better understanding of patient selection, best practices, and the severity of co-related complications