Necrosis can result from arterial occlusion by direct injection into an artery or embolization of product, typically presenting immediately with acute pain and blanching.
Skin necrosis is a very rare side effect of Voluma, and would only occur if the filler was causing compression of a blood vessel in the area it was injected. Signs of skin necrosis include changes in skin color (a blue, dusky, or dark hue in that area), pain, and “breakdown” of the skin.
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.
Necrosis can occur immediately or a few hours after treatment. Tissue death happens as a result of a blood vessel injury that is not promptly treated, so you should contact your doctor immediately if you experience severe pain, prolonged blanching or purple/grey discolouration around the injection site.
Answer: Not likely necrosis
As others have stated, usually necrosis happens very quickly. It looks more like a bruise which can take a while to resolve in the lips.
Symptoms can often be confusing and develop quickly
Early symptoms of necrotizing fasciitis can include: A red, warm, or swollen area of skin that spreads quickly. Severe pain, including pain beyond the area of the skin that is red, warm, or swollen. Fever.
It is important to note that while necrosis is a very real and serious complication of dermal filler treatments, actual occurrences are quite rare. Reports suggest that for all dermal filler treatments, only 1 in 100,000 result in a necrosis.
Inject with hyaluronidase.
When hyaluronic acid fillers are the culprit of necrosis, injecting with hyaluronidase might relieve the problem before complications even occur (Refer to the Aesthetic Complications Expert Group document on Hyaluronidase).
Answer: Necrosis vs bruising
Necrosis often has white AND flushed areas. What you have appears to be just normal bruising. Necrosis is often accompanied by terrible pain as well, as you can feel that the blood isn't circulating properly.
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.
It looks like bruising – but then you remember – skin necrosis, following a period of vascular occlusion, can also look like a bruise.
Necrosis essentially means 'tissue death' which can occur as a direct or indirect result of dermal filler treatment. Necrosis can occur immediately after the injection of fillers but may also present with a delayed onset due to the swelling and expansion of the filler.
Necrosis occurred in 2 of 4 cases in which the patient had been operated on within 3 hours of the injury, and our exploratory survival analysis estimates that 37% (95% confidence interval, 13%-51%) of all cases of ACS may develop muscle necrosis within 3 hours of the injury.
Necrosis is the death of the cells in your body tissues. Necrosis can occur due to injuries, infections or diseases. Lack of blood flow to your tissues and extreme environmental conditions can also cause necrosis. While dead body tissue can be removed, it can't be brought back to good health.
Necrosis cannot be reversed. When large areas of tissue die due to a lack of blood supply, the condition is called gangrene. Meningococcemia is a life-threatening infection that occurs when the bacteria, Neisseria meningitidis, invades the blood stream.
Wounds that have necrotic tissue present will not heal, therefore one of the above methods will be required to remove the devitalized tissue. Removal of necrotic tissue will decrease wound bacterial bioburden and will allow healthy tissue to grow in its place.
Necrosis begins with cell swelling, the chromatin gets digested, the plasma and organelle membranes are disrupted, the ER vacuolizes, the organelles break down completely and finally the cell lyses, spewing its intracellular content and eliciting an immune response (inflammation).
The loss of structural integrity of the plasma membrane is a hallmark of necrosis and represents the common final endpoint at which a cell can no longer maintain its discrete identity from the environment.
Skin necrosis takes 3-6 weeks to heal depending on the severity of the wound.
Treatment of necrosis typically involves two distinct steps. The underlying cause of the necrosis in wounds must be treated before the dead tissue itself can be dealt with. This can mean anything from administering antibiotics or antivenom to relieving pressure on the wound area to restore perfusion.
Methods: Although asymptomatic necrosis rarely needs treatment, brain necrosis resulting in neurologic change can be treated with steroids, surgery, bevacizumab and/or hyperbaric oxygen therapy.
There have been cases reported that occurred 12-24 hours after being injected but almost always it occurs immediately. If no treatment is initiated to improve the vascular flow, the skin will start to appear dusky, a bluish tint, with fine reticulations (lace like) to areas WELL BEYOND THE SITE OF INJECTION.
Some people have no symptoms in the early stages of avascular necrosis. As the condition worsens, affected joints might hurt only when putting weight on them. Eventually, you might feel the pain even when you're lying down. Pain can be mild or severe.