What are the signs of necrosis after lip fillers? Would my practitioner be able to tell straight away, if they're experienced?

Question

Hi I'd like to get lip fillers redone (I've had them before) but have since become aware of the most serious complication - necrosis. I'm extremely worried about this. How would I know what to look out for? Would my practitioner be able to tell straight away if they're experienced? Thank you in advance

Danielle Shanley, MD · Answer

Any injector should know the signs of a vascular occlusion. The first few signs would be blanching and immediate pain in the area. Luckily if treated in time, this is reversible and should not cause any permanent damage. If you are feeling uncomfortable or hesitant, I would make a consultation with your injector to address any concerns.

Nirmal Nathan, MD · Answer

Dear anon37910,Thank you for your question. Due to the robust blood supply to the lip, necrosis is extremely rare. Pain, mottling, and duskiness could be signs of early necrosis. If the filler is reversed promptly by an experience injector, worse effects should not happen, such as black, full thickness necrosis and ulceration. Good luck,Nirmal R. Nathan, M.D.
  
Certified, American Board of Plastic Surgery
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Robert M. Tornambe, MD · Answer

I appreciate your concern, however necrosis after injections with fillers is extremely rare. After years of experience with this procedure I have never seen it. However, an experienced injector can immediately identify early signs of this complication and minimize any problems by immediately injecting Hyaluronidase. Consult with a board-certified plastic surgeon or dermatologist for this procedure. Good luck.

Fadi Alhafez, MD · Answer

HI 
It is very rare for an experienced injector to encounter that but usually sever sudden pain occurs and either blanching or purple/black discoloration occur. Every injector must carry the dissolving agent handy in case this happens.

Fayaz Hasham, MD · Answer

Signs of Necrosis
1) Pain - might be difficult if Anaesthetic used
2) Blanching - area appears pale
3) Purple skin colour
4) Skin appears cold
If these are occuring the antidote is needed urgently

Back Kim, MD · Answer

Signs of necrosis after lip filler include immediate pain, blanching, and coolness of the skin. A skilled practitioner will know what to look out for, minimizing the chance of necrosis and taking immediate steps to correct the situation. We are so sorry to hear about this situation and would love to have you come in for a consultation so we can help you. Thank you!

Sara Taher, MD, FRACGP · Answer

hi there,
Usually symptoms happen as soon as blood vessel blocks. It can be severe pain or discolouration. It might happen few hrs later. If not treated Pimples and ulcers will appear.

Jeremy B. White, MD · Answer

Unusually severe pain and skin color changes are the most common signs of accidental blood vessel injection with filler. If this occurs, or you have concern about this, you should call your injector asap.

Fechner MD Plastic Surgery &amp; Medical Spa · Answer

Necrosis is a rare complication of lip fillers and choosing an injector who is aware of the signs and symptoms of intravascular occlusion is very important. It is also crucial to have an injector who is knowledgeable in regards to facial anatomy as well as safety mechanisms to prevent these risks from occurring. This risk can often be identified by your provider immediately as signs of blanching of the skin (white color) occur. Other symptoms include pain, skin discoloration and finally necrosis if left untreated. If needed, the filler can be dissolved with an enzyme known as hyaluronidase which works immediately.

Best,
Vanessa, NP

Best,
Vanessa, NP

Shaun Patel, MD · Answer

Lip filler treatments are very common and necrosis after this treatment is a rare complication. I have treated many patients with lip fillers and have never had this complication. Pain, skin color changes, and ulceration are all signs of necrosis.

What are the signs of necrosis after lip fillers? Would my practitioner be able to tell straight away, if they're experienced?

Answers (13)

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