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

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. 

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.

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

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.

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.

You do not have necrosis. Necrosis is associated with bad purple bruising ( a lot of spider web like bruising ) and typically pain . If you do not like the effects of the filler it can be reversed with Vitrase but all I can offer you is reassurance and patience

A photo does not justify evaluation for necrosis, however, typically skin necrosis is VERY painful.  The onset does not have to be immediately after filler. The most important thing is that you have injections performed by an expert in injectables who can handle side effects when they happen.  Treatment can involve a multi-approach, including dissolving the filler with hyaluronidase, intake of blood thinners, warmth to stimulate blood flow, and hyperbaric oxygen.  Smokers seem to fare worse than those who do not smoke.  I suggest seeing your injector or getting a second opinion from an expert. 

Thanks for your question. Although this does not clinically look like necrosis it is impossible to say just from looking at pictures. You must go back to see your injector if you are concerned as photos are no substitute for a good clinical examination