Nasolabial fillers, necrosis onset, advice? 4 days p.o. (photos)

Question

I had fillers in smile lines 4 dys ago, the right side fine but the left side feels tight & sore when I smile the left side does not raise as high as the right, feels like there is resistance, I am pretified it is restricting blood flow & the clump of filler is making the skin white & bruise, all she keeps sayin is it’s fine & massage the lump but what if it’s too late, how long does it take for the skin tissue to die if blood flow affected!

David M. Lieberman, MD · Answer

Thank you for the photos. It is difficult to give you a definitive answer. You should call your injector and go in for an in person follow up to be sure. That being said your photos don’t appear to be necrosis. Bruising and swelling are common for 10-14 days after filler is injected.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph. Had you suffered skin necrosis it would have declared itself by 4 days and more likely is that you have mild bruising present.  Given a couple of weeks you should see resolution of the bruising and softening of your fillers, affording you a more natural result.  Hope this helps.

Aldo Guerra, MD · Answer

Hello Tracy.These photos do not show necrosis. I see evidence of bruising. However, photos are tot a substitute for a thorough physical examination by your injector! I suggest you discuss you case with them directly. Best wishes, Dr. ALDO

Richard Brighton-Knight, MBChB · Answer

Hi Tracy
The feeling of tightness and being sore on one side could be due to bruising and is likely to gradually settle. The feeling of a lump being present also makes it more likely to be a bruise.
Blocking the blood flow is very rare, and the skin goes dusky/white with changes on the surface. Often this is visible at the time of injecting but can become visible at a later point. Ultimately it is always best to have a face to face review so that the area can be examined fully and problems with blood flow ruled out.

Glenn Messina, MD · Answer

Necrosis can occur with occlusion of an artery in almost any area that a filler is placed . The good news is I don't appreciate necrosis in your photos only some bruising and old fashion black and blues. Some warm soaks , arnica and time will resolve this.Necrosis has a pattern, at first the skin becomes white as the blood flow is cut off, its in a definite pattern going where the artery supplies the blood and oxygen. Often along with intense during pain, the pain may be blunted by the local but normally within 2 hours thats gone and the pain present. Over the next 24-36 hours the skin gets necrotic, dark and later breaks apart. I don't see any of this in your photos so I believe you can rest your mind.

Nasolabial fillers, necrosis onset, advice? 4 days p.o. (photos)

Answers (8)

Answer: Blood flow restriction is rare

Answer: Blood flow restriction is rare

Answer: Necrosis after dermal fillers

Answer: Necrosis after dermal fillers

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Nasolabial fillers, necrosis onset, advice? 4 days p.o. (photos)

Answers (8)

Answer: Blood flow restriction is rare

Answer: Blood flow restriction is rare

Answer: Necrosis after dermal fillers

Answer: Necrosis after dermal fillers

Browse related questions

Recommended reading

Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.