There are many different types of complications of dermal filler injections and some of them can be fatal. This is why even the most seasoned doctors should always practice caution during filler injections. In this article, we will take a look at necrosis, one of the most serious complications of dermal filler treatment.

 

Necrosis develops when the filler material is injected directly into a blood vessel or blocks the blood flow to the nearby tissues.  

 

Severe necrosis that is visually apparent take many stages. It is important to be able to recognize the precursors of necrosis. When appropriate treatment is performed at the early signs, necrosis can be prevented. However, if left untreated, it can develope into severe necrosis. One should have clear understanding of different stages of necrosis to prevent progress into severe necrosis.

 

Pathogenesis of necrosis

 

As I have mentioned already, it is crucial to understand the signs of different stages of necrosis. The filler is injected into a certain area to provide volume. And the injected area naturally experiences volume change. A foreign material injected to enhance the volume could interfere with the natural blood flow. Incorrect injection techniques can also cause necrosis.

 

The most common mistake is using a thin needle. Some may think thick needles are more dangerous but a thin needle could increase the pressure of injection and poses a greater threat. A thin needle needs to be injected with greater strength when inserted laterally into the tough skin. This also increases the pressure and the risk of complications.  

 

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Failure to adjust the right amount of filler can also lead to excessive swelling and necrosis. Some filler products tend to increase in volume after injection and can increase the pressure within the tissue and disturb the blood flow even after injecting a recommended dose. For example, Radiesse increases in volume 1.5 times in 30 minutes and subsides in 2 hours of injection. Ellanse increases in volume by about 30% immediately after injection and subsides in two days.  

 

Therefore, it is also important to be aware of filler properties before treatment. This is separate from overly aggressive techniques or swelling. Complications can be prevented when choosing the right filler for the procedure based on accurate knowledge of physical properties.

 

-To be continued

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