title: Impending skin necrosis after dermal filler injection: A "golden time" for first-aid intervention.
abstract: Vascular compromise with impending skin necrosis is one of the most serious potential complications. Early recognition of vascular occlusion and swift and aggressive treatment are required to avoid any irreversible changes. However, initial symptoms of a vascular event are often dismissed as simple post-procedural discomfort. If more than 3 days pass after filler injection, crust formation is initiated over the erythematous base along with a rim of fibrous tissue. Due to the replacement of normal tissues by fibrous material, the healing process may result in scar formation in spite of debridement and aggressive dressing changes. Scars often cause contracture and subsequent cosmetic disfigurement, which results in a traumatic burden to the patient. By sharing our experience of the patients with filler induced skin necrosis, we suggest that treatment should be initiated no later than 3 days after the procedure.
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Hong
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Joon
authors.initials: J
authors.lastname: Seok
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Ga Ram
authors.initials: GR
authors.lastname: Ahn
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Yu-Jin
authors.initials: YJ
authors.lastname: Jang
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Kapsok
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Beom Joon
authors.initials: BJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000009:adverse effects*; D003357:Cosmetic Techniques / Q000009:adverse effects*; D000067548:Dermal Fillers / Q000008:administration & dosage / Q000009:adverse effects*; D004890:Erythema / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D005392:First Aid / Q000379:methods*; D006801:Humans; D007279:Injections, Subcutaneous; D009336:Necrosis; D012867:Skin / Q000098:blood supply* / Q000473:pathology; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D014945:Wound Healing
chemical_list: D001672:Biocompatible Materials; D000067548:Dermal Fillers
keywords: Filler complication; skin necrosis; vascular compromise