The Risk of Skin Necrosis Following Hyaluronic Acid Filler Injection in Patients With a History of Cosmetic Rhinoplasty.

Robati RM, Moeineddin F, Almasi-Nasrabadi M. Aesthet Surg J. 2018 Jul 13;38(8):883-888. doi: 10.1093/asj/sjy005.PMID: 29506052

Abstract: As the number of patients using dermal fillers on the face increases, the number of adverse events related to the injection may increase. Unpredictable repositioning of blood vessels and a poorer blood supply to the operated nose may increase the risk of ischemia, necrosis, and vascular embolism after filler injection.


Objectives: To highlight the importance of the patient's history of previous aesthetic procedures including rhinoplasty in the occurrence of vascular complications.


Methods: Our medical records over a two-year period were retrospectively reviewed to identify all patients who were treated at our center for vascular complications associated with facial hyaluronic acid filler injections. In each case, the subject's demographic data (gender and age), general status, past medical and surgical history, symptoms and clinical presentation at the first visit, time interval between injection and onset of symptoms, filler material injected, and brand , injection sites, treatment presented and photographs were carefully reviewed.


Results: A total of seven patients were identified, each developing skin necrosis after hyaluronic acid filler injection. All patients reported a cosmetic rhinoplasty more than three years ago.


Conclusions: Our finding confirms the conjecture made previously in the literature and suggests that the distinctive vascularity of the nose and surrounding area may cause vascular complications caused by filler addition in patients whose vascular circulation is already compromised by previous surgery in nose