Correction of nasal skin necrosis after filler injection with micro and nanofat grafting

Vascular compromise leading to skin necrosis is the most serious complication of filler injection. This report presents two cases of nasal skin necrosis treated with microfat and nanofat grafting. Microfat was harvested from the thigh, rinsed with saline, and filtered through sterile gauze. Nanofat was produced by mechanically emulsifying the microfat. Microfat was injected into the pre perichondrium and subcutaneous layers, while nanofat was delivered into the subdermal and intradermal layers. Both patients showed satisfactory outcomes without complications. The nasal tips healed with soft, natural-looking skin indistinguishable from the surrounding tissue. This technique offers a cost-effective alternative for repairing skin necrosis, avoiding the need for debridement or more invasive procedures such as skin grafts or flaps, which may result in scarring and asymmetry.