Extensive necrosis after injection of hyaluronic acid filler: case report and review of the literature.

[BACKGROUND] Use of dermal fillers for soft tissue augmentation has become an integral part of aesthetic practices. Dermal fillers temporarily remove the appearance of rhytids and reduce the depth of skin folds. Even with the most experienced of injectors, adverse effects can and do occur ranging from mild bruising to severe injection necrosis.

[AIMS] Physicians should be able to treat the severe complication of vascular necrosis and detect impending necrosis after injection of a dermal filler, especially with hyaluronic acid fillers.

[MATERIALS AND METHODS] Case report of a patient who was followed for 6 months from time of injection of hyaluronic acid filler to complete healing of wound.

[RESULTS] Complete wound healing was achieved with early recognition and institution of treatment.

[DISCUSSION] We review a case report of injection necrosis and methods used to prevent and treat this complication.

[CONCLUSION] Early recognition of vascular necrosis with specific protocol for treatment after injection necrosis with hyaluronic acid fillers improves the outcome of wound healing.