Juvederm was injected into the blood vessels in my nose and my nose turned purple. Any suggestions?

This is a medical emergency and needs to be treated as such.  I suggest you see a filler expert for immediate treatment to prevent long term complications such as scarring and tissue loss.  In the future any fillers you have injected should be done with a microcannula to help decrease the chance of this occuring.  Best, Dr. Emer.

Thank you for your question. This seems to be an emergency and you need to be treated to further avoid complications. Please follow up with your injector immediately. All the best!

Thank you for
your question. This seems to be an emergency and you need to be treated to
further avoid complications. Please follow up with your injector immediately.
All the best!

This is why I've have stopped injecting noses with filler.  The complication rate is too high.  The question about checking for reflux is the safest way to check if you are in a vessel.  The problem is if the needle is too small or the filler is too thick, a "negative reflux" can give you a false sense of security.  You might actually be in the vessel but there is too much resistance to see blood flash back into the syringe.  Most HA's are too thick to get good reflux test, so that's why I prefer cannulas for these in all instances where a significant vessel injury is possible.  Sculptra is able to reflux because it is most saline/water.  With large needles, Voluma is too.  I suspect small needles were used in the nasal injection and they probably don't reflux.  The problem you have is a medical emergency and needs immediate hyaluronidase, heat, massage, and blood thinners.

Thank you for your question.Any type of filler injection, including the use of Juvederm, has the potential for inadvertent vascular injection. The fact that the skin immediately turned purple gives a high index of suspicion that this may have occurred, however, it may also be from compression of the vessels causing a stoppage of blood flow by the thickness of the medicine externally.  If left untreated, the skin and area supplied by the involved vessel may become necrotic. If skin is involved, this may lead to bad scars. If retinal vessels are involved blindness could result.  This is a true emergency situation and needs to be treated immediately.  Direct heat, nitroglycerin paste, injection with hyaluronidase  immediately are all indicated.  The fact that you are reporting this and it was recognized some time later, indicates there may be adequate collateral circulation and it may resolve without incident, but may take some time.  If discovered immediately or within the first few minutes, treatments are more likely to be successful in correcting or reversing the process.  The same supportive treatments done later are less likely to be effective, or may resolve spontaneously.  In any case, see your injector immediately and get expert advice and treatment.

The treatment of deep wrinkles could include many options.Fillers are but one of these options.An expert injector is a person who by training and medical specialty and  study has studied the aging process  the anatomy, physiology and function of the area treated.Fillers injections carry a certain amount of risk, like any other procedure. As patients you need to seek the best experienced specialist. You also need to understand the procedure, it's risks, and treatment of complications if they occur. An expert injector would understand what technique and precautions to take to prevent the complications. If complications occur must know how to treat, have all equipment and medications on hand and the expertise to diagnose,  to start treatment as soon as possible.Delay in treatment may cause more damage.

If you're not seeing an expert physician injector now, you should schedule an urgent consultation with one immediately. Filler injection into blood vessels can happen to even the most experienced injector but the key at this point is to find someone who can reverse the blood flow issues that have developed. This can involve hyaluronidase, nitropaste, warm compresses and a variety of other maneuvers. You will probably be best cared for by a plastic surgeon or dermatologist that will treat you personally as opposed to delegating your care to a non-doc. I wish you the best.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Withdrawal of the syringe should be done before any filler is injected if blockage of the blood vessels is a concern. Warm moist compresses as much as possible will cause the blood vessels to dilate and may restore some of the blood flow. You should also see your injector or other experienced physician as soon as possible. 

Your nose sounds like it may have compromised blood flow which is of major concern and needs to be addressed now. Please find a local expert to assist your situation and who can inject hyaluronidase to the compromised area if needed to dissolve the filler there. If you do have compromised blood flow and it is not properly addressed, you can have necrosis (tissue death), so please get to an expert asap. "This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."