Is this bruise a sign of necrosis from non-surgical nose rhinoplasty? (Photo)

Question

I had a non-surgical rhinoplasty on my nose (revolax sub q dermal filler) on Sunday. Immediately after I bruised very slightly from where a cannula was inserted. Today I went to have some of the filler dissolved because I didn't like the result. The bruise has darkened and turned a sort of purple (see photo - top bruise is the one I am referring to - the bottom marks are from the needles for hyaluronidase dissolver). I have scared myself ready reviews about necrosis. Could this be a vascular occlusion?

Eric M. Joseph, MD · Answer

If somebody develops vascular occlusion and necrosis, there is typically a path of redness, inflammation, and worsening of the condition. Since your doctor treated you with hyaluronidase, necrosis would have been noted at the time of the treatment. You probably just have a bruise, however, since you're concerned, please bring your concerns to the attention of your physician. I hope this helps. Sincerely, Dr. Joseph

Deniz Kanliada, MD · Answer

Thank you for the question and the photo.
Using cannula on the nose is more traumatic than the needles as you need to dissect tissues while moving the cannula to the area of injection. That colour change is due to the minor bleeding under your skin so it will heal in 10 days time.
Necrosis is very rare on the dorsum and it looks very dark when it happens. 
I hope this answer helps.

Best, Dr Deniz Kanliada
Facial Plastic Surgeon

Adam Goodwin, MBBS, FRCS(Plast) · Answer

So a few needles have been in your nose over the past few days. It looks like the trauma from all of that rather than anything more serious. Vascular occlusion would be rare on the nose as the blood supply is so good but even if it were, we would let nature control the progression and then treat any problems after a few weeks or even months. Let it all settle and I suspect it will all settle fairly soon. Hope that helps. Adam Goodwin

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