Nasal tip necrosis as a complication of hyaluronic acid fillers: case report and presentation of a new management technique

Hyaluronic acid fillers, whose use has increased significantly, can present complications, with the most severe being vascular occlusions that can lead to necrotic lesions. Various approaches have been proposed for the management of these lesions. The use of hyaluronidase is always necessary to dissolve the filler, causing the occlusion and debridement, and the use of antibiotics according to current guidelines is essential. This case report shows the favorable evolution of a necrotic lesion following a rhinoplasty with HA fillers using the author’s original protocol, which involves the intra- and perilesional injection of hybrid complexes of hyaluronic acid. Medical training, knowledge of facial anatomy, understanding of the rheology of fillers, and the use of high-purity and quality products are essential for preventing such injuries.