▶ Previous Artlcle: 1-2-side-effects-and-solution-of-fillers

 

Filler Necrosis

 

In order to carefully inject the filler in small quantity during a nose filler procedure with a 23G cannula, the cannula is moved back and forth over and over again. In this regard, there is a case where a filler necrosis occurred as the blood vessel of the dorsal nasal artery (DNA) was torn and the filler was injected through the blood vessel. The applicable patient was a male in his 30s whose nasal skin was thick and nose was crooked, all of which were difficult conditions for the filler procedure.

 

A biphasic filler was injected at a dose of 2cc at one time to correct the crooked and flat nose. The large injection volume and the frequent cannula movement to correct nasal deformity are judged to result in tearing of the blood vessel.

 

The jet of the cannula is on the side, and this jet is so sharp that it may tear the blood vessels. If the blood vessel gets torn, the pressure at the torn region becomes the lowest, allowing the filler to move via it and enter the blood vessel .

 

As the filler was injected into the blood vessel during the procedure, the pallor of the skin was momentarily observed. When the capillary refill time was normal and another skin discoloration was not observed after a sufficient massage, the patient was allowed to return home. However, the photos, sent by the patient when there was a happy call the next day, showed mottled skin appearance.

 

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Thus, the patient was advised to immediately revisit the hospital to initiate a treatment. This incident made the author realize once again that if the skin pallor occurs during a procedure, it would be wise to dissolve the entire filler injected without question.

 

Injection Necrosis

 

In a female patient in her 50s, an injection necrosis occurred when the fillers were injected with a 12G cannula into the nasolabial fold, the front cheekbone above the nasolabial fold, and under-eye area. To be specific, the pathogenesis of injection necrosis involves the movement of the cannula to the region below the left nasal wing in order to correct the drooping region during the filler injection into the left nasolabial fold.

 

When blanching was observed at that time of the procedure, a massage was performed, but as the skin gradually showed a mottled pattern, the fillers were immediately dissolved and subsequently a treatment was initiated.