Is necrosis a legitimate concern of non surgical nose job ?

Question

I've had a non surgical nose job before and loved the results. I moved and went to a new provider--she mentioned that necrosis is possible and I need to weigh that into risks associated with the procedure. My prior provider did not tell me that! What's the verdict?

William Dougherty, MD · Answer

Yes, it is a legitimate concern. But the risk is very low in experienced hands. It should, however, be discussed before placing nasal fillers as part of informed consent. Correct technique minimizes the risk, so finding a provider who is familiar with facial and nasal anatomy is key. Hope this helps!

Eric M. Joseph, MD · Answer

Temporary gel fillers are thick. They can compress blood vessels, or sometimes they can be embolized and cause a stroke or blindness. If you are considering a temporary gel filler, please make sure that your injector is knowledgeable of the vascular anatomy of the nose, and how to treat these complications should they occur. In our practice, we utilize microdroplet Silikon-1000 for permanent non-surgical nose job treatments. Since the size of a Silikon-1000 molecule is smaller than a red blood cell, none of those complications have been reported. Thank you for your question. Sincerely, Dr Joseph

Elham Jafari, MD · Answer

Hi and thank you for your question! While rare, injection of fillers can interfere with blood flow - when filler is injected inadvertently into a blood vessel which is extremely rare with proper technique but can have catastrophic consequences, but more commonly when the filler exerts some pressure on a nearby vein and slows its blood flow. There are blood vessels on nose and given the limited space, there is the risk but it is very low. After almost ten years and several thousands of filler injections, I have never seen any patients with filler injected into a blood vessel, but perhaps 3-4 patients with signs consistent with filler pressuring on a nearby vein but even those cases all had full recovery with injecting some enzyme and topical application of vasodilators. So to sum it up, yes the risk is there and we all must be aware of it, but it is very small and you and your injector should be vigilant on the warning signs to be able to manage it quickly if it occurs. I hope it helps and good luck!

Nelson Lee Novick, MD · Answer

I have personally been performing nonsurgical filler rhinoplasties for nearly two decades, since the early days when Radiesse, a calcium-based filler was first being used for this purpose. At the beginning, this five minute technique was used almost exclusively for straightening bumpy, humped nasal bridges. Later, its uses expanded to include raising droopy tips and treating certain nasal asymmetries. These days, most experienced injectors use hyaluronic acid-based volumizing fillers, such as Restylane Lyft or Hyabell Deep for these purposes. While vascular occlusion and necrosis are potential adverse reactions, fortunately, given the very large number of people treated, these kinds of reactions are quite unusual. What's more, hyaluronic acid injectables can be quickly dissolved and necrosis averted with the timely and aggressive use of hyaluronidase (a hyaluronic acid dissolving enzyme). So, continue to feel comfortable and best of luck.

Daniel Barrett, MD · Answer

Dear mtimko,
there is a risk of necrosis when using dermal fillers and it should be discussed prior to injections. I would recommend finding a plastic surgeon to perform you injections.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Tanveer Janjua, MD · Answer

It is a legitimate risk to get fillers in the nose. The risk of a vessel occlusion or compression leading to skin necrosis is there and rarely blindness as well.However, the risk is small and if done by an experienced injector it will achieve good results in a safe manner. RegardsDr. J

Ronald J. Edelson, MD · Answer

I have never heard of necrosis from non surgical rhinoplasty but I suppose it’s possible. I think you doctor was just being thorough. It would be worth asking her how many of these she has done because not everyone does the procedure and if she’s ever seen that complication.

Kim Patrick Murray, MD · Answer

One of the main reasons I’m not a big fan of non-surgical rhinoplasty, also the results are usually less than amazing when seen from more than one angle / in person. And you’re limited in terms of what you can do with reshaping compared to surgical rhinoplasty. So the risk / reward ratio is kinda off

Matthew Bridges, MD, FACS · Answer

Tissue necrosis from fillers is a concern in any region of the face, including the nose.  Just Google it and you will see some scary photos. Your injector should always mention this as a risk, especially in the nose.

Mahyar Amjadi, FRACS (Plast) (license conditions) · Answer

Hi!
Fillers carry a lot of risks, and fortunately most of them are very rare. But with filler in any part of your face, skin necrosis, and even blindness, are possible risks, and both have happened to people, although very rarely. So keep calm, but be aware!
All the best

Is necrosis a legitimate concern of non surgical nose job ?

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