Complications of orofacial harmonization

We read, with great enthusiasm, the article ‘’Complications in orofacial harmonization procedures: a systematic review’’ by Manganaro et al. (2022)¹, published in issue 37(2) of the Brazilian Journal of Plastic Surgery. The manuscript was very well prepared, and we congratulate the authors. However, we consider it important to highlight some reflections:

Regarding facial fillers, the material of choice is hyaluronic acid. Unfortunately, complications arising from using hyaluronic acid have been occurring, mainly due to the performance of non-medical health professionals. The dental surgeon and co-author of this letter (RRC) considered the hyaluronic acid application in her nose by another dental surgeon for aesthetic purposes. In a few days, the immediate ischemia evolved into necrosis, causing deformity caused by scar retraction (Figure 1A). Seven surgical repair procedures have already been performed by Plastic Surgery without, however, achieving the expected results² (Figure 1B).

Figure 1
A: Nasal necrosis after 6 days of hyaluronic acid application; B: Current appearance, after the 7^th reparative plastic surgery.

Our study group has been presenting on possible complications of other orofacial harmonization procedures performed by dental surgeons^{3 4 5}. In addition to the possible complications, we have warned about the judicialization of these complications at the ethical-administrative level and the civil, consumer, and criminal actions involved in these situations⁶. Considering the possible complications arising from these procedures, which are mostly treated by Plastic Surgery, we, the authors of this Letter to the Editor, are against the performance of orofacial harmonization by dental surgeons.

REFERÊNCIAS

• ¹
  Manganaro NL, Pereira JGD, Silva RHA. Complications in orofacial harmonization procedures: a systematic review. Rev Bras Cir Plást. 2022;37(2):204-17.
• ²
  Pedron IG, Cavalcanti RR, Gaujac C, Shinohara ÉH. Comments on Bouaoud and Belloc, 2020: “Use of injectables in rhinoplasty retouching: towards an evolution of surgical strategy? Literature review”. J Stomatol Oral Maxillofac Surg. 2020;121(6):751-2. DOI: 10.1016/j.jormas.2020.09.004
  » https://doi.org/10.1016/j.jormas.2020.09.004
• ³
  Cavalcanti RR, Pedron IG. Bichectomy (buccal fat pad reduction) and your implications. Sci Arch Dental Sci. 2020;3(9):43-4.
• ⁴
  Cavalcanti RR, Pedron IG. Rhytidoplasty and blepharoplasty performed by dental surgeons: imminent risks. Sci Arch Dental Sci. 2021;4(7):21-2.
• ⁵
  Cavalcanti RR, Pedron IG. Rhinoplasty and alectomy (nasal wing reduction) performed by the dental surgeon: another mistake! Sci Arch Dental Sci. 2021;4(8):22-4.
• ⁶
  Cavalcanti RR, Pedron IG. Dentistry and Litigation. Sci Arch Dental Sci. 2020;3(8):1-2.

Publication Dates

• Publication in this collection
  19 May 2023
• Date of issue
  2023

History

• Received
  23 Aug 2022
• Accepted
  13 Sept 2022