Skin Integrity Blog

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04 Jun 2013

Cosmetic Disasters

Stephen Wassall

As dermal fillers have become increasingly popular the number of reports of side effects has increased.  Most side effects are relatively minor and short lived but tissue necrosis is a rare but potentially serious and can lead to permanent scarring if not detected early and managed appropriately.

What is necrosis?

Necrosis refers to tissue death.  It leads to ulceration and scarring.  In the case of dermal fillers it is caused by inadvertent injection of product into an artery.  This blocks the circulation which starves the skin of oxygen and leads to skin breakdown.  Fortunately, if this complication is recognised early it can be treated with a substance known ashyalase in order to dissolve the dermal filler.

  

Tissue necrosis following dermal filler injection


What are the Symptoms of Necrosis?

Some of the symptoms that filler has been injected into the artery and that necrosis is occurring are as follows:

  • Persistent pain after injection
  • Persistent whiteness or redness in or around the area of the injection site
  • Small pimples in or around the area of the injection site
  • Persistent skin bruising or ulceration
It is important to realise that the symptoms of necrosis don't always occur at the actual site of injection.  For example, filler injection at the side of the mouth can cause necrosis on the tip of the nose.  This is because the artery that supplies the tip of the nose runs past the side of the mouth.

Minimising Your Risk

Dermal Fillers are now injected by a variety of Practitioners varying in knowledge, skill and experience.  A few points to consider:

  • Dermal fillers, anti-wrinkle injections and hyalase are all prescription medications and can only be prescribed by a doctor.  Nurses injecting prescription medication without doctor authorisation and support are acting illegally.
  • Your injector should be contactable and readily available in case of a medical emergency.  Necrosis is a medical emergency and must be diagnosed and treated early.  
  • The treatment for necrosis requires injection of a prescription medication known as hylase.  Hyalase can cause severe  allergy (anaphylaxis).  Any practitioner or clinic using hyalase should have immediate access to oxygen, adrenaline and a defibrillator.  
  • Beauty and Hairdressing salons are not medical facilities and not equipped to deal with emergencies such as anaphylaxis or necrosis.  Doctors and nurses that work in this environment frequently travel to numerous locations and may not be available to manage complications in a timely manner.
  • You should be confident that your injector is experienced and has detailed understanding of facial anatomy and potential complications of the procedures they perform.  Early necrosis can be difficult to diagnose.
  • Permanent and semi-permanent fillers can't be dissolved.  Hyaluronic acid based fillers are considered much safer due to the ability to dissolve them with hyalase.

IF YOU THINK YOU MAY HAVE SUFFERED TISSUE NECROSIS AS THE RESULT OF FILLER INJECTION PLEASE CONTACT YOUR INJECTOR IMMEDIATELY.  IF THEY ARE UNAVAILABLE PLEASE CONTACT SKIN INTEGRITY FOR ADVICE OR PRINT THIS PAGE AND TAKE IT TO THE NEAREST HOSPITAL EMERGENCY DEPARTMENT.

SKIN INTEGRITY OFFERS COSMETIC CLIENTS THE FOLLOWING BENEFITS
  • SAFETY: A genuine medical clinic offering safety, discretion, hygiene, sterility and the ability to deal with emergencies. These standards are not available in Beauty Salons with visiting practitioners.
  • VALUE: The best prices for injectable cosmetic treatments performed by a doctor on the Central Coast.
  • EXPERIENCE: Dr Wassall has been practising Cosmetic Medicine since 2002 and has performed over 10 000 procedures.
  • REWARDS: Cosmetic clients of Skin Integrity will also have the option of receiving access to Special Offers and Promotions. These include discounts on anti-wrinkle injections and dermal fillers.