The Risk of Skin Necrosis Following Hyaluronic Acid Filler Injection in Patients With a History of Cosmetic Rhinoplasty

Robati RM, Moeineddin F, Almasi-Nasrabadi M.

PubMed 29506052 Publisher (DOI)

What this paper says

All seven patients treated at one Iranian centre over two years for skin necrosis after facial hyaluronic acid filler had undergone cosmetic rhinoplasty more than three years earlier, supporting the view that an operated nose has a compromised blood supply that raises filler risk.

Overview

An operated nose has rearranged and reduced blood vessels. The authors retrospectively reviewed two years of records for vascular complications after facial hyaluronic acid filler, recording demographics, history, presentation, timing, product, site and treatment.

Sections of note

Seven patients identified, all with skin necrosis after hyaluronic acid filler.
All seven reported cosmetic rhinoplasty more than three years before.
The authors conclude the finding confirms earlier conjecture that prior nasal surgery increases the risk of ischaemia, necrosis and embolism after filler.

What it means for a patient

If you have had rhinoplasty, filler in or near the nose carries a higher risk of blocking a blood vessel and damaging skin.
Tell any injector about previous nasal surgery, even decades ago.
Seven cases with no comparison group cannot say how much higher the risk is, only that the association is consistent.

Why this paper matters

It is an early clinical series linking prior rhinoplasty to filler necrosis, a warning later reviews repeat. Limits: seven patients, no denominator, single centre.

Terms

Skin necrosis: death of skin from loss of blood supply.
Ischaemia: inadequate blood flow to tissue.
Vascular embolism: filler entering and blocking a blood vessel.
Hyaluronic acid filler: the most common injectable gel for reshaping.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“As the number of patients using dermal filler for face augmentation increases, the number of adverse events associated with injection may increase. Unpredictable repositioning of blood vessels and a more tenuous blood supply in the operated nose may increase the risk of ischemia, necrosis, and vascular embolism…”

Excerpt; the full abstract is on PubMed.