Juvederm chin reaction necrosis vs infection progress (Photo)

This is vascular occlusion and needs topical wound care with antibiotics and scar gel (not neosporin), oral aspirin, topical nitroglycerine, and you should have injection of hyaluronidase.  I suggest hyperbaric oxygen treatments and in a few weeks starting lasers.  Please PLEASE see an expert.  Best, Dr. Emer.

Thank you for your question and series of photographs. I am glad to see that your chin has progressed in a positive way and the that your injector is treating you appropriately.  This will take time to heal and you will see some skin flaking, but it should only improve from here.  I would continue to heed your physician's advice as they have the best idea as to how you are progressing and your tissues are reacting.  Best wishes!

After seeing your before picture the other day, I am glad to see where you are now.  There is no risk to continuing the regimen for now although the nitropaste is likely unnecessary now.  The residual redness will certainly take time to fade and may need to be treated with a vascular laser in 4-6 weeks.  The sensitivity should return to normal as the skin heals.  Continue to use an emollient cream several times a day, and use a sun screen daily and avoid sun exposure to the area.

Since the new photo shows skin changes the night of the injection, it most likely is a vascular event. It seems like you are improving with current therapy. The nitropaste is not needed. I would still cover with antibiotics because bacteria love tissue that is compromised. It's possible laser treatment might be needed in future to maximize your outcome such as the VBeam or Excel V. Biafine is great to improve would healing too, and might expedite improvements. 

I am glad that it is healing. Make sure you follow up with the injecting doctor closely and regularly.BestDr Karamanoukian#RealSelf100 Member

You will OK after the dissolving agent. There is a slight difference in protocol with each doctor. I  personally would not use the nitro paste, considering the time frame and the fact you had it dissolved. Good work to get it so early! My feeling is this was a vascular accident, diagnosed and managed very well. Antibiotics? I use them as anti-inflammatories in this setting, as well as to prevent infection. I am pretty sure you will recover without any problems. I normally follow up my parents with another lot of injections (possibly) 24 hours after the first, but let your Specialist guide you.All the best Dr Davin LimLaser DermatologistBrisbane, Australia.