title: Management of impending necrosis associated with soft tissue filler injections.
abstract: BACKGROUND
  As the number of soft tissue filler injections increases, the number of adverse events associated with injection may rise. Impending necrosis represents a serious complication that, if not treated correctly and timely, may have grave consequences.
  
  
  OBJECTIVE
  We describe a protocol utilizing hyaluronidase, nitroglycerin paste, aspirin, antacid and a topical oxygen therapy that may be used to treat impending necrosis subsequent to injection with soft tissue fillers.
  
  
  CONCLUSIONS
  We have successfully treated nine post-filler injection adverse events involving impending necrosis or necrosis following both hyaluronic acid and calcium hydroxylapatite injections using our protocol.
authors: Chicago Center for Facial Plastic Surgery, Chicago, IL 60611, USA. sdayan@drdayan.com
authors: Steven H
authors: SH
authors: Dayan
authors: John P
authors: JP
authors: Arkins
authors: Clyde C
authors: CC
authors: Mathison
mesh_terms: D000328:Adult; D000863:Antacids / Q000008:administration & dosage; D001241:Aspirin / Q000008:administration & dosage; D003357:Cosmetic Techniques / Q000009:adverse effects*; D017886:Durapatite / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage; D007267:Injections; D009336:Necrosis; D005996:Nitroglycerin / Q000008:administration & dosage; D010100:Oxygen / Q000008:administration & dosage
chemical_list: D000863:Antacids; D006820:Hyaluronic Acid; D017886:Durapatite; D006821:Hyaluronoglucosaminidase; D005996:Nitroglycerin; D001241:Aspirin; D010100:Oxygen