Ischemical Problems After Filler Injection to The Nose

Vascular Complications After Nose Filler Injection

Circulation problems due to nose filler,Risks of non-surgical nose job,Ischemical problems after filler injection,
Circulation problem on the nose that occurs after cross-linked hyaluronic acid filler injection. Photographs taken on days 1-8 and 13, respectively. After the treatment, it is seen that the symptoms gradually decrease and become close to normal.


Filler injection to the nose is a very simple procedure that can be done in office conditions. When the correct application technique and safe products are used, the risk and complications of non-srugical nose job are very low.

Generally, the most used and most reliable products in nose filler procedures are filling materials containing hyaluronic acid. About 1 month ago, a patient who developed skin discoloration, pus flowing areas on the nose after cross-linked hyaluronic acid filler injection in another clink, followed by bruising complaints applied to our clinic. The above photographs show the photographs taken immediately after the injection of elephants into the nose and then taken every day until the 8th day, and finally the photograph taken on the 13th day.

It has been learned that the filler injected into the fault is a CE certified and quality product. When paying attention to the area with color change on the nose that appeared on the first day of the patient, it is seen that the infection with inflamed areas is added within a few days after the lesion starts in the form of a sharp line in the form of a bruise.

In the foreground, the patient was diagnosed with circulatory disorder and skin infection due to the injection of elephants and the following protocol was followed:

- Use of ciprofloxacin derivative antibiotic tablets
- Putting the towel soaked in water heated to about 60 degrees on the nose for a few minutes and taking a break for a few minutes.
- Cialis 20 mg tablet, one tablet a day (this product may effect response is to increase blood flow on the nose and it may cause to flushing as side effect but its mean increase the blood circulation)
- While hyaluronidase enzyme injection was planned as soon as possible, it was not performed due to the normalization of the skin color in the follow-up of the patient.
- Hyperbaric oxygen treatment was not planned, as the patient did not form a nexrosis line and gradually improved healing properties.

Factors that increase the risk of circulatory disorders in the nose after nose filler injection

- Planning the nose filler procedure for patients who have previously had various filling reactions or similar problems (even if the elephant material is not injected into the vein during the elephant injection; it may cause a decrease in capillary circulation due to the mass effect and pressure, therefore, in noses with circulation problems already. avoiding this process is ideal)

- Injection of large amounts of filler substance (usually injecting a very small part of the filller injector at the first time, I prefer to do it 2 or 3 times a month on average every 2 weeks. Fillers containing cross-linked hyaluronic acid are the most preferred all over the world. Generally, once a single product is opened, an application is made every 2 weeks. The most accurate application is to do it little by little and evaluate the patient herself at the same time with the hand mirror. If the injector is not finished, the patient comes 3 times in 1 month, and if the injector runs out for the second time, it comes twice in total. This triple application is healthier and can extend the duration of action).

- Using products with quality and purity problems. It is inconvenient to use non-bandro-based products from the Far East and the European Quality Standards Regulation (CE) of uncertain purity. There are semi-permanent and permanent fillers, both the price and the risk increase, patients generally prefer hyaluronic acid and decide whether they are satisfied with the filler or not and see the result.

How to understand if circulatory disorders occur during non-surgical nose job?

Since many physicians are full of nasal anatomy, they avoid injecting into the vein in the areas where the vessels pass through, and during the injection, they pull back the plunger of the syringe and check whether the tip of the needle is in the vein. However, it should be kept in mind that capillary circulation may be adversely affected due to the compression effect of the filling, and excessive injection should be avoided. Generally, the sharply circumscribed whitening that occurs immediately after the injection can be exaggerated on the skin, and then a lesion in the form of a bruise may appear, as seen in the photographs. In the patient I shared with you here, a skin infection also occurred and antibiotic treatment was given especially for gram-negative bacteria. In other words, it is necessary to be careful in terms of color changes that can be seen different from bleeding and bruising that may occur during injection. In the photo on the right, the nose photograph of the patient is seen on the 4th day after the nose filler injection.

Especially in patients with recurrent nasal operations, the risk of circulatory disorders in the nose may be higher and it may be appropriate to avoid a large amount of filler injection at the first time by choosing a thick needle.

There is no tissue loss and color change on the patients's nose currently and I am very happy with this situation. 

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Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com 
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47



  

 


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