Complications of bullhorn surgery: prevention and correction

Objective. To analyze postoperative complications following bullhorn surgery and propose methods for their prevention and surgical correction. Material and methods. A retrospective study enrolled 532 patients who underwent bullhorn surgery for aesthetic causes between 2014 and 2023. There were bullhorn procedures alone in 213 (40%) cases and combinations with other methods of cheiloplasty (corner lift, VY cheiloplasty, removal of biopolymer gel from lips, as well as m. depressor anguli oris (DAO) resection) in 319 (60%) cases. Results. All patients were divided into two large groups: 505 (94.9%) patients with normal postoperative period and 27 (5.1%) patients with postoperative complications. Complications were divided into early and late ones in different age groups. Complications occurred in patients with previous injections of hyaluronic acid-based fillers prior to surgery. Methods for prevention of complications were developed. Surgical treatment of complications in delayed period was proposed. Conclusion. Compliance with patient selection, preoperative marking, and surgical techniques will avoid most complications after bullhorn surgery.