title: Injection necrosis of the glabella: protocol for prevention and treatment after use of dermal fillers.
abstract: BACKGROUND
  Injection of filler materials into the dermis is well tolerated, with few mild and transient side effects. Injection necrosis is a rare but clinically important potential complication caused by interruption of the vascular supply to the area by compression, injury, and/or obstruction of the vessel(s). The glabella is a particular danger zone for injection necrosis regardless of the type of filler used.
  
  
  OBJECTIVE
  We recommend a protocol that may be used to help prevent and treat injection necrosis of the glabella after injection with dermal fillers.
  
  
  CONCLUSIONS
  Injection necrosis in the glabellar region may be prevented by knowledge of the local anatomy and an understanding of its pathophysiology and treated by a suggested protocol.
authors.affiliation: DermSurgery Associates, Houston, TX 77030, USA.
authors.forename: Adrienne S
authors.initials: AS
authors.lastname: Glaich
authors.forename: Joel L
authors.initials: JL
authors.lastname: Cohen
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Goldberg
mesh_terms: D001672:Biocompatible Materials / Q000008:administration & dosage / Q000009:adverse effects*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002985:Clinical Protocols; D057487:Enzyme Therapy; D005546:Forehead / Q000098:blood supply*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects* / Q000031:analogs & derivatives; D006821:Hyaluronoglucosaminidase / Q000627:therapeutic use; D007271:Injections, Intradermal; D009336:Necrosis / Q000188:drug therapy / Q000209:etiology / Q000628:therapy; D005996:Nitroglycerin / Q000627:therapeutic use; D040521:Subcutaneous Tissue / Q000473:pathology*
chemical_list: D001672:Biocompatible Materials; D002317:Cardiovascular Agents; D006495:Heparin, Low-Molecular-Weight; D006820:Hyaluronic Acid; D006821:Hyaluronoglucosaminidase; D005996:Nitroglycerin