Utilization of Leech Therapy after Rhinoplasty
Research article published in Plastic and reconstructive surgery (2022)
Abstract
BACKGROUND: The use of medicinal leeches in modern reconstructive surgery is well-described. Leech therapy after rhinoplasty has not been previously well-characterized. METHODS: The medical records of all patients who underwent open rhinoplasty by a single surgeon over a 4-year period were reviewed. Patient demographics, including age, sex, medical comorbidities, number of previous rhinoplasty surgeries, time to utilization of leech therapy, adjunct therapies used, resolution of skin changes, and smoking status, were recorded. Operative reports were reviewed for pertinent information, including number of tip grafts used, graft materials used, and placement of septal extension grafts or "unicorn" grafts. RESULTS: Between April of 2016 and March of 2020, 545 patients underwent rhinoplasty performed by the senior author (P.S.N.). Of these patients, 39 (7.2 percent) underwent leech therapy postoperatively. The mean age of included patients was 47.4 years. Of the patients who required leech therapy, 34 (87.2 percent) had undergone revision rhinoplasty. The mean number of previous rhinoplasties was 3.4. The mean number of tip grafts used was 2.6. Thirty-three patients (84.6 percent) had either a traditional septal extension graft or unicorn graft placed. Nine patients (23.1 percent) were former smokers. Complete resolution of skin color changes was seen in 38 patients (97.4 percent). There were no major complications after leech therapy. CONCLUSIONS: Leech therapy is a useful tool for the rhinoplasty surgeon, particularly in the setting of complex revision rhinoplasty, in patients who have undergone multiple previous nasal surgical procedures, or in patients who require significant cartilage grafting to reconstruct the nasal tip or lengthen the nose. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
A retrospective review of 545 rhinoplasty patients identified 39 (7.2%) who received postoperative leech therapy, with complete skin color resolution in 97.4% and no major complications, particularly after revision surgery or extensive cartilage grafting.
Why This Matters for Hirudotherapy
This study reports a single-surgeon experience with postoperative leech therapy following open rhinoplasty, in which 39 of 545 patients (7.2%) received leech treatment—predominantly after revision procedures (87.2%)—with complete resolution of adverse skin color changes observed in 97.4% and no major complications. This work is directly relevant to hirudotherapy, providing clinical outcome data on medicinal leech use in facial plastic surgery and reinforcing the established role of leech therapy in managing compromised tissue perfusion across reconstructive contexts. The findings reflect one surgeon's practice and patient population, provide no data on leech species, salivary secretome components, or pharmacologic mechanisms underlying the observed clinical effects, and do not establish optimal treatment protocols for broader application.
Citation
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