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.
Early signs of necrosis usually appear soon after the filler injection, either immediately or hours after the procedure. Many cases of necrosis occur after injection, but there are also papers describing delayed necrosis.
You might notice these symptoms 24 hours after your procedure. Contact your provider if you experience pain or skin color changes at the site of your dermal filler. Reduced blood flow to parts of your body can cause dangerous and irreversible consequences if you don't receive treatment quickly.
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.
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.
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.
As with any medical procedure, there are risks involved with the use of dermal fillers. 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.
The stages of avascular necrosis can be divided into four main categories: pre-collapse, early collapse, late collapse, and arthritis.
Signs of vascular occlusion
Temporary blanching is non-threatening and will resolve on its own. 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.
The most important sign of occlusion is poor capillary return on the affected area. In comparison, a bruise will have quick capillary return. The bruising is contained in a certain location and takes on a relatively defined shape, as opposed to discoloration, spreading and a mottled appearance.
How do I know if my lip filler is infected? Signs of an infected lip filler include pain, tenderness, swelling, redness, warmth or pus at the injection site within the first week after the procedure. Any of these symptoms indicate the need to see a doctor immediately for evaluation and treatment with antibiotics.
The best results of dermal fillers are seen typically 1 to 2 weeks post treatment with some of the swelling and bruising dissipating by then. It could take up to 4 weeks for everything to completely settle down, at which point you will notice the results you're expecting.
Vascular occlusion is one of the rare complications of dermal filler treatment. It may happen as early as receiving the injectable filler or as late as 24 hours post-treatment.
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.
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.
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.
The mortality increases from 5%-25% in patients with sterile necrosis to 15%-28% when infection occurs[13].
We'll be brutally honest here: the appearance of necrosis after filler is not for the faint of heart. 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.
After your first dermal filler appointment, you want to avoid any hot and humid place. For example, don't rush to the sauna or a hot tub right after your treatment. The high heat makes swelling in your face a lot worse.
These reactions, occurring months after injection, can include swelling, inflammation, and infections. The research highlights the importance of patient selection, high-quality products, and strict hygiene to minimize risks, providing valuable guidelines for practitioners to ensure safer aesthetic treatments.
There are two main types of necrotic tissue present in wounds. One is a dry, thick, leathery tissue usually a tan, brown, or black color. The other is often yellow, tan, green, or brown and might be moist, loose, and stringy in appearance. Necrotic tissue will eventually become black, hard, and leathery.
Signs of necrosis after having a filler injected can occur immediately or hours after the procedure. These signs include: More pain and discomfort than expected after treatment.
It's important to seek care quickly if you have developed signs and symptoms of necrotizing fasciitis as this infection spreads fast.