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

Overview

An operated nose has rearranged and reduced blood vessels. The authors retrospectively reviewed two years of records for vascular complications after facial hyaluronic acid filler, recording demographics, history, presentation, timing, product, site and treatment.

Sections of note

• Seven patients identified, all with skin necrosis after hyaluronic acid filler.
• All seven reported cosmetic rhinoplasty more than three years before.
• The authors conclude the finding confirms earlier conjecture that prior nasal surgery increases the risk of ischaemia, necrosis and embolism after filler.

What it means for a patient

• If you have had rhinoplasty, filler in or near the nose carries a higher risk of blocking a blood vessel and damaging skin.
• Tell any injector about previous nasal surgery, even decades ago.
• Seven cases with no comparison group cannot say how much higher the risk is, only that the association is consistent.

Why this paper matters

It is an early clinical series linking prior rhinoplasty to filler necrosis, a warning later reviews repeat. Limits: seven patients, no denominator, single centre.

Terms

• Skin necrosis: death of skin from loss of blood supply.
• Ischaemia: inadequate blood flow to tissue.
• Vascular embolism: filler entering and blocking a blood vessel.
• Hyaluronic acid filler: the most common injectable gel for reshaping.