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Impending Facial Skin Necrosis and Ocular Involvement After Dermal Filler Injection: A Case Report

  • Case Report
  • Non-Surgical Aesthetic
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Abstract

Demand for non-surgical rejuvenating procedure is constantly increasing due to the aging population, increasing expense of aesthetics and beauty procedures, introduction of new applications and rising demand for noninvasive aesthetic procedures over surgical procedures. Skin necrosis is a rare but severe potential complication. It is caused by impediment of the blood supply to the skin area by compression and/or obstruction of the vessel with filler material, and/or direct injury to the vessel. We report the case of a young patient who presented an acute and severe complication after a dermal filler injection by an unlicensed therapist. High-dose corticosteroids i.v. therapy among others helped in the process of healing. Skin necrosis left the patient with a full thickness scar on the forehead region. Dermal fillers are to be considered safe only when handled by trained doctors.

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References

  1. American Society of Plastic Surgeons (2012) Plastic surgery procedural statistics. http://www.plasticsurgery.org/news/plastic-surgery-statistics/2012-plastic-surgery-statistics.html

  2. Hanke CW, Higley HR, Jolivette DM et al (1991) Abscess formation and local necrosis after treatment with Zyderm or Zyplast collagen implant. J Am Acad Dermatol 25:319–326

    Article  CAS  PubMed  Google Scholar 

  3. Schanz S, Schippert W, Ulmer A et al (2002) Arterial embolization caused by injection of hyaluronic acid (Restylanes). Br J Dermatol 146:928–929

    Article  CAS  PubMed  Google Scholar 

  4. Sun ZS, Zhu GZ, Wang HB et al (2015) Clinical outcomes of impending nasal skin necrosis related to nose and nasolabial fold augmentation with hyaluronic acid fillers. Plast Reconstr Surg 136(4):434e–441e

    Article  CAS  PubMed  Google Scholar 

  5. Bravo BSF, De Balassiano LKA, Da Rocha CRM et al (2015) Delayed-type necrosis after soft-tissue augmentation with hyaluronic acid. J Clin Aesthet Dermatol. 8(12):42–47

    Google Scholar 

  6. Beleznay K, Humphrey S, Carruthers JD et al (2014) Vascular compromise from soft tissue augmentation: experience with 12 cases and recommendations for optimal outcomes. J Clin Aesthet Dermatol 7(9):37–43

    PubMed  PubMed Central  Google Scholar 

  7. Beer K, Downie J, Beer J (2012) Treatment protocol for vascular occlusion from particulate soft tissue augmentation. J Clin Aesthet Dermatol 5(5):44–47

    PubMed  PubMed Central  Google Scholar 

  8. Cavallini M, Gazzola R, Metalla M et al (2013) The role of hyaluronidase in the treatment of complications from hyaluronic acid dermal fillers. Aesthet Surg J 33(8):1167–1174

    Article  PubMed  Google Scholar 

  9. Van Dyke S, Hays GP, Caglia A et al (2010) severe acute local reactions to a hyaluronic acid-derived dermal filler. J Clin Aesthet Dermatol 3(5):32–35

    PubMed  PubMed Central  Google Scholar 

  10. The British Association of Aesthetic Plastic Surgeons. BAAPS consumer safety guidelines. http://baaps.org.uk/safety-in-surgery/consumer-safety-guide-lines. Accessed 2 Feb 2016

  11. The American Society for Aesthetic Plastic Surgery. Patient Safety Guidelines by ASAPS. http://www.surgery.org/consumers/patient-safety/archived-patient-safety-tip-articles/patient-safety-guidelines-by-asaps

  12. Chen Q, Liu Y, Fan D (2016) serious vascular complications after nonsurgical rhinoplasty: a case report. Plast Reconstr Surg Glob Open 4(4):e683

    Article  PubMed  PubMed Central  Google Scholar 

  13. Scheuer JF 3rd, Sieber DA, Pezeshk RA et al (2017) Anatomy of the facial danger zones: maximizing safety during soft-tissue filler injections. Plast Reconstr Surg 139(1):50e–58e

    Article  CAS  PubMed  Google Scholar 

  14. Signorini M, Liew S, Sundaram H et al (2016) Global aesthetics consensus group. global aesthetics consensus: avoidance and management of complications from hyaluronic acid fillers-evidence- and opinion-based review and consensus recommendations. Plast Reconstr Surg 137(6):961e–971e

    Article  CAS  PubMed  Google Scholar 

  15. Feller-Heppt G, Haneke E, Heppt MV (2014) Diagnosis and management of filler adverse effects: an algorithm. Facial Plast Surg 30(6):647–655

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

All patients have been informed of potential publication, and all steps to ensure patient confidentiality have been taken. All authors have had access to all data, have seen and approved this manuscript and have no financial conflicts or other interests to disclose.

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Correspondence to Francesco Ciancio.

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Salval, A., Ciancio, F., Margara, A. et al. Impending Facial Skin Necrosis and Ocular Involvement After Dermal Filler Injection: A Case Report. Aesth Plast Surg 41, 1198–1201 (2017). https://doi.org/10.1007/s00266-017-0898-8

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  • DOI: https://doi.org/10.1007/s00266-017-0898-8

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