How quickly does necrosis occur after filler?

Author: Joany Rutherford  |  Last update: Monday, August 18, 2025

The symptoms of ischemia can occur immediately after the injection or several hours after the procedure. Here, the authors report three cases of necrosis after hyaluronic acid injection with the first symptoms presenting only several hours after the procedure.

How quick does necrosis happen?

Symptoms of necrotising fasciitis can develop quickly within hours or over a few days. At first you may have: intense pain or loss of feeling near to a cut or wound – the pain may seem much worse than you would usually expect from a cut or wound. swelling of the skin around the affected area.

What are the first signs of impending necrosis?

SIGNS AND SYMPTOMS OF NECROSIS
  • Pain. 2,3,5,6,7 Severe pain is usually experienced by the patient when necrosis ensues. ...
  • Prolonged blanching. 2,3,5,7 When the vasculature is affected, the area will often initially look very pale, white, or dusky due to the reduction in blood supply. ...
  • Dusky, purple discoloration. ...
  • Coolness.

How common is necrosis from fillers?

Impending necrosis has been reported involving all types of filler with incidences estimated at 0.001 percent for collagen and HA. Over the last three years, there have been nineteen patients referred to our clinic for evaluation and management of severe adverse events following soft tissue filler treatments.

How soon does vascular occlusion happen after filler?

If you have a vascular occlusion after a dermal filler, you could experience symptoms 12 to 24 hours after your filler procedure. Vascular occlusion is a serious condition that needs medical treatment immediately.

VO countdown: How soon after treatment can you spot a vascular occlusion?

What does vascular occlusion look like immediately?

After the initial injection, the next sign of a problem with a VO is usually pallor. In the case of a true, complete vascular occlusion, pallor is very stark, particularly in lips. There will be a grey patch on the lip that sometimes has zero capillary refill.

How long after fillers can you get complications?

Most side effects associated with dermal fillers, such as swelling and bruising occur shortly after injection and many resolve in a few days to weeks. In some cases, side effects may emerge weeks, months, or years later. Common risks include: Bruising.

Does filler necrosis happen immediately?

The symptoms of ischemia can occur immediately after the injection or several hours after the procedure. Here, the authors report three cases of necrosis after hyaluronic acid injection with the first symptoms presenting only several hours after the procedure.

How long does tissue necrosis take to develop?

Avascular necrosis is the death of bone tissue due to a lack of blood supply. Also called osteonecrosis, it can lead to tiny breaks in the bone and cause the bone to collapse. The process usually takes months to years.

How do you know if you hit an artery with fillers?

Bruising may occur if an artery or blood vessel has become blocked due to filler injection. Bruising may range from a blue discoloration to a dusky purple-grey appearance. Swelling is likely to occur in and around the injection site if vascular obstruction is present, and may range from mild to severe.

What does early stage necrosis look like?

The skin may look pale at first but quickly becomes red or bronze and warm to the touch and swollen. Pain is intense. Later, the skin turns violet, often with the development of large fluid-filled blisters (bullae). The fluid from these blisters is brown, watery, and sometimes foul smelling.

What is Tyndall effect filler?

What is the Tyndall effect? The Tyndall effect is a rare phenomenon in which a patient's skin takes on a bluish tone after he or she receives dermal fillers. This discoloration is most often visible in the skin below the eyes due to the area's thin skin.

What does the start of necrosis feel like?

There may be no symptoms of osteonecrosis at first, but as the disease progresses, you may gradually start to feel pain, especially in weight-bearing bones such as the thigh bone (femur). The disease most commonly affects the hip joint, and the pain is usually felt in the groin or, less commonly, in the buttock area.

What does skin necrosis look like after fillers?

In this case, necrosis often turns the skin blue or gives it a blue cast. It can also result in pustules and a scaly look along with white plaques. Sometimes the affected skin turns black. The necrosis is not only difficult to look at but also quite painful.

How quickly does skin necrosis spread?

The infection can spread rapidly within hours; hence, suspicion should be high for necrotizing fasciitis in intense pain.

What are the 4 stages of necrosis?

The stages of avascular necrosis can be divided into four main categories: pre-collapse, early collapse, late collapse, and arthritis. Pre-collapse Stage: This stage is characterized by minimal to no symptoms, and the bone damage can only be detected through imaging tests such as an MRI or X-ray.

How fast does necrosis set in?

There is no definitive answer to 'how fast does avascular necrosis progress'; it could take 12-18 months, or it could develop much more rapidly over a few months. Hip pain is usually the first indicator of AVN. However, AVN has four stages. A healthy hip with no symptoms.

How long after surgery does necrosis start?

In some cases, necrosis may become apparent shortly after surgery, within the first few days or weeks, due to immediate complications such as compromised blood supply or surgical trauma.

What causes rapid tissue necrosis?

RTN (Rapid Tissue Necrosis) occurs when a coral colony or portion of the colony loses its tissue rapidly. Typically coral loses its tissue within 24 hours. FACT: The number one cause of RTN are the Philaster Lucinda and Philaster Guamense parasites.

What are the first signs of vascular occlusion from fillers?

  • Pain. Severe pain is usually experienced by the patient at the time of injection. ...
  • Blanching. When the vasculature is affected, the area will often initially look pale, white, or dusky, due to the reduction in blood supply to the affected tissue. ...
  • Dusky, purple discoloration. ...
  • Coolness.

What is a delayed onset reaction to fillers?

Delayed-onset (late) inflammatory reactions (DIRs), such as nodules, granulomas, and edema, have been reported after injection of almost any dermal filler but are more common when using permanent fillers.

How do you know if your body is rejecting fillers?

If you experience any signs of an allergic reaction after a filler injection, such as tenderness, swelling or asymmetrical fullness, seek medical attention immediately. Ask your doctor to test for allergies to the injectable fillers and/or the liquid gel in which they are suspended.

When should I be worried about fillers?

Increased redness, pain, swelling and heat around the lips hint at an infection. The presence of pus is also very worrying, and a professional must be consulted as quickly as possible.

How long after filler can you have a reaction?

Delayed hypersensitivity reactions are characterized by induration, erythema, and edema and are mediated by T lymphocytes rather than antibodies. They typically occur 48–72 hours after injection but may be seen as late as several weeks postinjection and may persist for many months.

What is a pillow face?

“Pillow face” occurs when too much filler is injected into areas like the cheeks, nasolabial folds (the lines from your nose to the corners of your mouth), lips, and under-eye area. This repeated overfilling can result in a bloated, round appearance that looks far from natural.

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