title: Delayed-type Necrosis after Soft-tissue Augmentation with Hyaluronic Acid.
abstract: The growing use of dermal fillers, specifically the use of hyaluronic acid, can be explained by their effectiveness and versatility as well as their favorable safety profiles. Nevertheless, early and late complications with varying levels of severity may occur. The incidence of complications is low and the majority of adverse events are mild (edema, erythema, and local ecchymosis) and of limited duration. However, more severe events, such as ischemia and necrosis, may occur. 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. The patients were treated immediately after the diagnosis. The aim of this review is to communicate the possibility of the delayed-type presentation of necrosis, present the signs and symptoms that lead to early diagnosis, and review the treatment possibilities of this severe complication.
authors.affiliation: Institute de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro and Hospital Federal da Lagoa - Rio de Janeiro, Brazil;
authors.forename: Bruna
authors.initials: B
authors.lastname: Souza Felix Bravo
authors.affiliation: Policlinica Geral do Rio de Janeiro, Brazil;
authors.forename: Laila
authors.initials: L
authors.lastname: Klotz De Almeida Balassiano
authors.affiliation: Hospital Federal da Lagoa - Rio de Janeiro, Brazil;
authors.forename: Camila
authors.initials: C
authors.lastname: Roos Mariano Da Rocha
authors.affiliation: Policlinica Geral do Rio de Janeiro, Brazil;
authors.forename: Carolina
authors.initials: C
authors.lastname: Barbosa De Sousa Padilha
authors.affiliation: Institute de Dermatologia Prof. Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro - Rio de Janeiro, Brazil;
authors.forename: Carolina
authors.initials: C
authors.lastname: Martinezt Torrado
authors.affiliation: Dermatologist, Rio de Janeiro, Brazil;
authors.forename: Roberta
authors.initials: R
authors.lastname: Teixeira Da Silva
authors.affiliation: Institute de Dermatologia Prof. Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro and Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
authors.forename: João
authors.initials: J
authors.lastname: Carlos Regazzi Avelleira