Do I have nose necrosis after fillers? I got fillers on my nose tip earlier today. Now my entire nose is bruised. (Photos)

Question

I only got injections on the tip but my entire nose has dark spots now and one side of the tip is very dark.

Stephen Giordano, DO · Answer

Although these pictures make it less likely to make an accurate diagnosis, this does not appear to be necrosis. Honestly, I don't even see much bruising with the exception of a little punctate spot on your right side.  Some bruising is to be expected.  Necrosis generally would be painful, and give more "color" changes to the skin that is white, red, purple variations.   I'm fairly sure this is not necrosis, but you need to see your provider ASAP if you are still concerned.  Time is of the essence to prevent damage as there is a treatment available.   Best to you, Dr. Giordano

Philip S. Schoenfeld, MD, FACS · Answer

I have been consulted for tip necrosis following rhinoplasty surgery and it does not look like the photos that you have provided.  I cannot say that you do not have some element of nasal tip vascular compromise or simply bruising.  If you push on your tip gently and watch the skin turn white or light  (blanching of the skin) then release the pressure and watch the light tip skin regain color, then you know there is good capillary refill and likely no chance of tip necrosis.  Obviously, a call to your injector is a very good idea as well.

Lewis Albert Andres, MD · Answer

Hello!  It is difficult to assess on your photos alone. However, given your submitted photos and your description, I would recommend following up immediately to assess the area. Following any injection, the vascularity may become compromised and is always a concern. Any changes from the norm is urgent and should be brought to somebody’s attention immediately. Best wishes!

Daniel Barrett, MD · Answer

Dear germangirl1990,it is hard to tell for sure without an examination but based on your photo, it doesn't look like a necrosis. If you are concerned, I would suggest you to consult your plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jason Emer, MD · Answer

It's difficult to tell from your picture. Bruising can be typical and will last 1-2 weeks. Since you're concerned, I recommend following up with your injector. If necessary, the filler can be reversed with hyaluronidase. Best, Dr. Emer

Sheryl D. Clark, MD, FAAD · Answer

Germangirl1990, in the second photo there appears to be a lacy, reticular pattern to the discoloration. This means there is either compression of a vessel from filler around it or a small amount of filler within the vessel. You need to be seen immediately to prevent necrosis of the skin. Treatment should be effective if started early. See the practitioner who performed the injections or any advanced, board-certified dermatologist or plastic surgeon who can see you ASAP today. Please let me know how you fare.
Dr. ClarkPS I just checked your profile, hope that’s okay. Prior rhinoplasty predisposes one to this complication. Please be sure to share your history with any physician tending to you.

Nicholas Gentry, MD · Answer

It is difficult to say for sure but I would call and follow up today before the weekend. If it is necrosis it may not be too late to minimize damage - an exam is necessary to see fr sure

Pamela Stuart, MD · Answer

From your photos it is difficult to determine. But since you mentioned your entire nose was now bruised, I would definitely recommend that you speak with your injector and have a follow up as soon as possible. If you have any concerns, I would not wait but seek their advice today. Best wishes,

Anteneh Roba, MD · Answer

It’s very difficult to tell from your photo whether you have bruising or something more serious. I would suggest consulting with your injector.

Inessa Fishman, MD · Answer

It's difficult to answer your question completely based on the photos provided.  That said, to have bruising or discoloration in parts of the nose not injected is worrisome.  Do you have pain?  Did your injector use a needle or a cannula?  You would do best to have an in-person evaluation by the person who treated you or another physician experienced in injectable fillers.  Please contact your injector with your concerns as soon as possible, as vascular occlusion and inadequate tissue blood flow are time-sensitive and pressing issues.  Contact a Dermatologist or a Plastic Surgeon ASAP if you cannot reach your treating physician.

Do I have nose necrosis after fillers? I got fillers on my nose tip earlier today. Now my entire nose is bruised. (Photos)

Answers (10)

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