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Perlane-scared of Necrosis

asked 1 year ago by silviamari in Toronto, ON
Latest answer by Grant Stevens, MD
Question viewed 781 times
Tags: necrosis

what are the odds of skin necrosis after filling large areas like cheeks and chin? I want to get it done, I'am ready to pay for it, but I'am scared of this side effect, can someone help me??

13 answers to Perlane-scared of Necrosis

+3

Risks from filler injection

The risks from injecting hyaluronic acid fillers are small. The risk of inadvertent injection into a vessel into the glabella or the nasolabial area (the supratrochlear artery or the angular artery) is small, but can occur.  It is of course nice to know the anatomy to avoid those two blood vessels. The other way that problems occur is if large volumes are placed in a single area.  this predisposes to skin necrosis above the injection site, such as for "liquid... more
Brent Moelleken, MD

Beverly Hills Plastic Surgeon
+2

Perlane and skin necrosis

It is a possiblity that when a filler is injected that it can cause tissue necrosis because of an intravascular injection, but it is extremely rare.  No one knows the exact incidence because there ahve not been many reported cases in the probably millions of injections performed.  It is probably like getting struck by lightening.
Steven Wallach, MD

Manhattan Plastic Surgeon
+2

Perlane-scared of Necrosis

Try multiple small injection amounts over a month or 6 weeks to build up the effect. This will allow the chance of any necrosis occurring to be decreased to nothing. From MIAMI Dr. Darryl J. Blinski, 305 598 0091. 
Darryl J. Blinski, MD

Miami Plastic Surgeon
+2

Perlane Necrosis Risk During Cheek and Chin Treatment

The risk of skin necrosis with Perlane injection using proper injection technique is very rare. As usual, I would make sure you consult with a cosmetic surgeon or dermatologist with a wealth of experience injecting fillers. Discuss the areas you are looking to improve, your concerns and expectations with your surgeon and then decide whether to proceed or not. Know that many millions of patients have successfully been treated with Perlane and other fillers without complications.... more
Anifat Balogun, MD

Seattle Facial Plastic Surgeon
+2

Perlane necrosis is very uncommon

 I have never seen necrosis associated with Perlane therapy and have used it for many years on many patients. I have seen many talks on this potential side effect and the few times it had occurred was when people were treated in the glabella and the peri-alar area. I would advise against treating the glabella . The peri-alar area should only be treated by a skilled dermatologist or plastic surgeon and then the risk is present but uncommon.
Steven Hacker, MD

West Palm Beach Dermatologic Surgeon
+2

Skin necrosis is extremely rare with proper Perlane injection technique.

In order for skin necrosis to occur, enough Perlane must be inadvertently injected into an arteriole to completely block blood flow to the area of skin that the vessel supplies. If enough circulation impairment  is caused, the skin in that area dies (necrosis). Since facial skin has such a rich blood supply, this would take a large amount of Perlane concentrated in a vessel big enough to supply a discrete area of skin. Other blood vessels help provide oxygen and... more
Richard H. Tholen, MD, FACS

Minneapolis Plastic Surgeon
+1

Perlane is safe and effective

Greetings Silviamari~ Perlane is a great way to re-volumize the face and areas that you feel may have become sunken over time. It's good to be aware of risks and complications but don't become too overwhelmed by them. The risk of necrosis with Perlane comes from occlusion of a blood vessel. If this occurs, hyaluronidase can be injected to dissolve the Perlane that is causing the problem and the event can be stopped in its tracks. Bruising and swelling are... more
Grant Stevens, MD

Los Angeles Plastic Surgeon
+1

Skin necrosis after Perlane injection

The risk of skin necrosis following a Perlane injection is extremely small. I personally have never seen it in my practice. While the chances are remote, they have been reported in the medical literature. There is one area where the risk of skin necrosis is higher - the nose. The incidence in the nose is much higher, even with a 'thinner' substance like Restylane, so I would be much more careful in this area. I don't recommend this for the majority of patients, as the... more
Ryan Greene, MD, PhD

Fort Lauderdale Facial Plastic Surgeon
+1

Risk of necrosis from Perlane filler is small

Fortunately in the area of the cheek and chin there is very good blood flow so the risk of necrosis is small. However, there has been at least one report of filler injected near the smile fold at the corner of the nose that compromised the circulation but necrosis was averted with the injection of hyaluronidase. If the area gets infected that would be another concern, but doing the filler in smaller amounts and multiple sessions can also be done if the physician has concerns about the... more
Ronald Shelton, MD

Manhattan Dermatologist
+1

The risk is very small

Perlane is a hyaluronic acid filler. That means that if an inadvertent injection occurs into a blood vessel, or compresses a blood vessel, it can be dissolved before tissue necrosis can occur. The way to  prevent a  vascular injection is slow injections using a constant movement so no large bolus can occlude the vessel. Another very important consideration is whether the paient smokes. Smoking compromises the collateral circulation and increases the risk that a vascular... more
Mary Lupo, MD

New Orleans Dermatologist
+1

Risk of necrosis after Perlane injection is small

The risk of necrosis is extremely small with Perlane.  Any time a filler is injected into an artery/arteriole, there is a risk of necrosis.  Some areas of concern are the glabella (area between eyebrows) as vessels are relatively superficial there and if injected with the hyaluronic acid filler may cause necrosis due to cut-off of blood supply.  That is also possible at the very top of the nasolabial folds by compression of the angular artery running there. Thankfully,... more
Emily Altman, MD

Short Hills Dermatologic Surgeon
+1

Necrosis Risk with Fillers Highest in Nose and Glabella

One of the reasons to choose a board-certified physician is that all areas of filler injection are not the same.  Some areas such as the naso-labial fold carry a fairly low risk of complication, others such as the glabella carry a higher risk.  By choosing a well trained physician, you will avoid potential problems and get a fantastic result.
Joseph Campanelli, MD

Minneapolis Facial Plastic Surgeon
+1

Perlane-Associated Skin Necrosis is VERY Rare

Skin ulceration and death (necrosis) may be seen whenever a filler or fat is injected into an end artery causing a blockage. This is a rare complication wil all fillers but especially of thicker fillers. For this reason injection techniques are done with a moving needle to minimize the amount of filler placed in any one location. The risk is minimal and is particularly rare when caution is used but it can never be reduced to zero. If you are not willing to accept even the very remote of... more
Peter A. Aldea, MD

Memphis Plastic Surgeon

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