Can Latera Improve Appearance?
Physicians have been using injectable dermal fillers to tweak the shape of the nose for more than 15 years. However, practicing physicians have noticed an uptick in demand, which they attribute to social media posts that suggest fillers as an easy, low-cost way to improve appearance.
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June 2020Latera is a nice procedure for a directed problem, meaning nasal valve collapse. It won’t do anything for a septal deviation or turbinate hypertrophy, but as an isolated procedure, I do consider it a useful tool in my armamentarium. —Krista Olson, MD
The reality, of course, is that injecting fillers into the nose is a relatively high-risk procedure, as side effects can include blindness and skin necrosis. “What we call ‘filler rhinoplasty’ or ‘non-invasive rhinoplasty’ may have a little role within the world of rhinoplasty, but it has a huge, potentially catastrophic downside,” Dr. Park said. Additionally, fillers dissolve in about a year, so any cosmetic improvement is limited.
For most patients who desire a new-and-improved nose, surgical rhinoplasty remains the best option. But can Latera also improve appearance?
As part of the two-year follow-up study of Latera insertions, independent physicians reviewed before and after photos of patients to assess for cosmetic changes. Initially, no negative cosmetic changes were noted by either the physician reviewers or patients. At 18 months post-procedure, independent physician reviewers noted “significant cosmetic improvement” in five subjects. At 24 months, one subject had experienced noticeable adverse cosmetic changes and one subject had significant cosmetic improvement (Facial Plast Surg. 2017;32:233-240).
Some, including Latera inventor Dr. Saidi, think the device may be a useful tool to enhance appearance. “We know that cosmetic changes of the noses can be best achieved by appropriately building and correcting the structural elements of the nose,” he said. “If a house has a leaning porch, breaking down one side just so it’s symmetric is not as good as fixing the side that’s weak.”
Other physicians are skeptical of Latera’s utility for cosmetic change. “I would not expect that it would have a significant impact on the appearance of the nose,” Dr. Olson said. “Certainly, it isn’t going to replicate the changes we see with cartilage grafting.”
Dr. Toriumi agreed, noting the fact that, overall, Latera typically doesn’t impact a patient’s appearance either positively or negatively. “For significant, long-lasting cosmetic change, a surgical rhinoplasty is still the best option,” Dr. Toriumi said.
Appropriate selection of patients and expert delivery and positioning of Latera or dermal fillers are key to the successful use of these products for minimally invasive rhinoplasty.