Arch Aesthetic Plast Surg.  2012 Oct;18(3):138-141.

Multiple Embolism after Injection of Hyaluronic acid Filler in Nasal Dorsum: A Case Report of Skin Necrosis, Blindness, Oculomotor Palsy and Cerebral Infraction

• Oh S

Abstract

As hyaluronic acid filler commonly applied in many cosmetic fields, tissue necrosis due to filler embolism is reported infrequently. Herein we report the first case of nasal hyaluronic acid filler injection resulting in nasal necrosis, multifocal brain infarction and ocular ischemia with hypotonia. A 25-year-old female, who had received an injection of hyaluronic acid filler along the nasal dorsum a month before, visited our hospital to manage the skin ulcer of nasal ala. Immediately after the injection, the patient had complained of nausea, vomiting, headache and nose pain without neurologic symptom. The skin had bluish change at her nose and forehead. And the right eyelid ptosis was observed with decreased eyeball movement and visual loss. Multifocal punctuated infarctions were found on both frontal lobes on brain MRI. The necrotic skin of right nasal ala was healed in 3 months. But, the width of the right nasal ala was smaller than the left side, and the right eye remained blind with extropia at 8 months after injection. Although hyaluronic acid filler is safe in most cases, patients should be informed of the possibility of this rare complication.

Keyword

Embolism; Hyaluronic acid

MeSH Terms

Adult
Blepharoptosis
Blindness
Brain
Brain Infarction
Cosmetics
Embolism
Eye
Female
Forehead
Frontal Lobe
Headache
Humans
Hyaluronic Acid
Infarction
Ischemia
Muscle Hypotonia
Nausea
Necrosis
Neurologic Manifestations
Nose
Paralysis
Skin
Skin Ulcer
Vomiting
Cosmetics
Hyaluronic Acid