Secretome-Assisted Regenerative Therapy for Hyaluronic Acid Filler-Induced Vascular Occlusion: A Case Report

Hyaluronic acid (HA) fillers are widely used for non-surgical facial contouring, but vascular occlusion remains one of the most feared complications due to its potential to cause necrosis, functional impairment, and permanent deformities. Conventional management focuses on high-dose hyaluronidase and supportive therapy, which may not always prevent long-term sequelae. In recent years, regenerative approaches such as secretome and mesenchymal stem cell (MSC) therapies have emerged as promising alternatives. We report the case of a 29-year-old woman who developed nasal vascular occlusion following HA filler injection by a non-medical injector. Initial presentation included localized pain and cutaneous necrosis in the nasal tip. Early management involved repeated hyaluronidase infiltration, oral sildenafil, a single dose of prednisone, and adjuvant intravenous peroxidation therapy. Subsequently, 12 local applications of standardized MSC-derived secretome were administered. This strategy promoted granulation tissue formation, re-epithelialization, and partial recovery of skin integrity. However, clinical persistence of nasal asymmetry suggested cartilage involvement. To address this, an additional injection of 10 million MSCs was performed, leading to stable cutaneous coverage and improvement of nasal contour within 45 days. At the two-year follow-up, the patient showed a stable scar with mild hypopigmentation and surface irregularity. This case highlights the translational potential of regenerative therapies as an alternative to reconstructive surgery in filler-induced vascular complications. Secretome demonstrated efficacy in soft tissue repair, while MSCs contributed to structural restoration. Regenerative strategies may expand the therapeutic arsenal for HA filler-related vascular events, offering non-surgical and biologically targeted options for tissue preservation and functional recovery.