Impending skin necrosis after dermal filler injection: A "golden time" for first-aid intervention

Dermatol Ther. 2017 Mar;30(2). doi: 10.1111/dth.12440. Epub 2016 Nov 28.

Abstract

Vascular compromise with impending skin necrosis is one of the most serious potential complications. Early recognition of vascular occlusion and swift and aggressive treatment are required to avoid any irreversible changes. However, initial symptoms of a vascular event are often dismissed as simple post-procedural discomfort. If more than 3 days pass after filler injection, crust formation is initiated over the erythematous base along with a rim of fibrous tissue. Due to the replacement of normal tissues by fibrous material, the healing process may result in scar formation in spite of debridement and aggressive dressing changes. Scars often cause contracture and subsequent cosmetic disfigurement, which results in a traumatic burden to the patient. By sharing our experience of the patients with filler induced skin necrosis, we suggest that treatment should be initiated no later than 3 days after the procedure.

Keywords: Filler complication; skin necrosis; vascular compromise.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biocompatible Materials / administration & dosage
  • Biocompatible Materials / adverse effects*
  • Cosmetic Techniques / adverse effects*
  • Dermal Fillers / administration & dosage
  • Dermal Fillers / adverse effects*
  • Erythema / diagnosis
  • Erythema / etiology
  • Erythema / therapy*
  • Female
  • First Aid / methods*
  • Humans
  • Injections, Subcutaneous
  • Necrosis
  • Skin / blood supply*
  • Skin / pathology
  • Time Factors
  • Time-to-Treatment*
  • Treatment Outcome
  • Vascular Diseases / diagnosis
  • Vascular Diseases / etiology
  • Vascular Diseases / therapy*
  • Wound Healing

Substances

  • Biocompatible Materials
  • Dermal Fillers