Filler and Hyaluronidase after Rhinoplasty (Photo)

Question

I was injected with filler for a notch in my right nostril (photo1), which showed after rhinoplasty, and with steroid to improve swelling. I got vascular occlusion and my nose got purple (photo2). I received two Hyaluronidase injections over 8 days. My nose did not go to necrosis but the skin became dark (photo3). While it improved, it has not changed color much in three weeks (photo4). Also, the skin gets darker when I am outside. Will this resolve? How long it will take? What should I do next?

Eric M. Joseph, MD · Answer

Thankfully, you have significant improvement in the coloration of your nose, compared to the event. I suspect that the color of your nose will go back to baseline in time. For this reason I think it's best to wait. If you have persistent discoloration, depending on the colors, intense pulsed light treatments may be considered, depending on your examination.

When we fill small divots and indentations after rhinoplasty, we exclusively use microdroplet Silikon 1000. This is a permanent soft tissue filler, and the size of a silicon 1000 molecule is smaller than a red blood cell so vascular occlusion never occurs. I hope you get a complete recovery. Thank you for your question. Sincerely, Dr. Joseph

Mats Hagstrom, MD (license on probation) · Answer

I think you should count your blessings that you did not necrosis the tip of your nose.
When the body loses blood supply to a certain region, the tissues typically create a stimulus for the in growth of surrounding blood vessels.
This is sometimes referred to as development of collateral vessels, a delay, effect, or neovascularisation 
For now I would hold off and not intervene and give this a year or two to see how things develop.
Well, this is an unfortunate complication. You’re also extremely lucky that your occlusion did not necrosis your nose.
Best,
Mats Hagstrom, MD

Filler and Hyaluronidase after Rhinoplasty (Photo)

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Filler and Hyaluronidase after Rhinoplasty (Photo)

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