Comparing Options for Minimally Invasive Rhinoplasty

In 2018, the global minimally invasive surgery market was worth $36.5 billion. According to a report by Research and Markets, global demand for minimally invasive surgery is expected to expand over the next few years—by 2024, the market will likely be worth $58.2 billion.

The trend toward minimally invasive surgery, of course, extends across all healthcare disciplines and is driven by the desire to provide convenient, high-quality, cost-effective care. Why pay for a lengthy hospital stay if the same outcome can be achieved via outpatient surgery or an in-office procedure? The risk of blood loss and infection can also be decreased by choosing a minimally invasive option, and patients can typically resume their usual activities sooner after minimally invasive surgery than traditional open surgery.

Patients and physicians have two choices for minimally invasive rhinoplasty: injectable dermal fillers, which can be used to reshape the nose (sometimes called “liquid rhinoplasty”; see “Liquid Rhinoplasty: How to Make Patients Aware of the Risks” in the April 2020 issue of ENTtoday), and Latera, a dissolvable nasal implant that can be used to support the upper and lower lateral nasal cartilages to prevent and treat nasal valve constriction or collapse.

“Latera and liquid rhinoplasty are comparable in the sense that they can both be done in a less invasive way than traditional rhinoplasty, potentially under local rather than general anesthesia,” said Iyad Saidi, MD, PhD, inventor of Latera and an otolaryngologist in private practice in Franconia, Va. (Dr. Saidi is the co-founder of Spirox, the company that developed Latera, and retains an interest in sales of the device.)

However, Latera and liquid rhinoplasty treat completely different issues: Latera is intended to correct a structural, functional issue; liquid rhinoplasty addresses cosmetic concerns. Yet, these two minimally invasive options have one more similarity: Both are probably best for only a small subset of patients who need or desire rhinoplasty.

“My belief is that Latera has a small but legitimate place in functional rhinoplasty and, quite frankly, the same with filler rhinoplasty,” said Stephen S. Park, MD, chair of the department of otolaryngology–head & neck surgery, and director of the division of facial plastic and reconstructive surgery at the University of Virginia School of Medicine in Charlottesville. “For a very small subset of patients, filler rhinoplasty may be a good option, particularly when performed by surgeons who understand the vascular anatomy of the nose. Similarly, for Latera, there are some very specific patients for whom it makes sense; it can be a reasonable option when inserted by surgeons who understand the pathophysiology of nasal obstruction, the precise anatomic etiology, and where to place the device.”