Case Reports of Adipose-derived Stem Cell Therapy for Nasal Skin Necrosis after Filler Injection

Abstract

With the gradual increase of cases using fillers, cases of patients treated by non-medical professionals or inexperienced physicians resulting in complications are also increasing. We herein report 2 patients who experienced acute complications after receiving filler injections and were successfully treated with adipose-derived stem cell (ADSCs) therapy. Case 1 was a 23-year-old female patient who received a filler (Restylane) injection in her forehead, glabella, and nose by a non-medical professional. The day after her injection, inflammation was observed with a 3×3 cm skin necrosis. Case 2 was a 30-year-old woman who received a filler injection of hyaluronic acid gel (Juvederm) on her nasal dorsum and tip at a private clinic. She developed erythema and swelling in the filler-injected area A solution containing ADSCs harvested from each patient's abdominal subcutaneous tissue was injected into the lesion at the subcutaneous and dermis levels. The wounds healed without additional treatment. With continuous follow-up, both patients experienced only fine linear scars 6 months postoperatively. By using adipose-derived stem cells, we successfully treated the acute complications of skin necrosis after the filler injection, resulting in much less scarring, and more satisfactory results were achieved not only in wound healing, but also in esthetics.

An Islanded Rabbit Auricular Skin Flap Model of Hyaluronic Acid Injection-Induced Embolism

“…In the 13 flaps having clinical necrosis, this combined necrosis was found in 11 flaps. Our findings were consistent with the clinical presentations of HA embolism cases [6][7][8][9][10][11][12], which suggested that not only arterial occlusion but also venous occlusion was involved.…”

“…A recent study demonstrated that it was the accidental intra-arterial injection that caused the ischemia, rather than external vascular compression on distal perfusion [5]. Ischemia with subsequent skin necrosis mainly occurs in the glabella [6,7], nose [7][8][9][10][11][12], forehead [7,8], nasolabial fold [10], and cheek [13]. Moreover, intracranial artery embolism can lead to blindness caused by retinal artery occlusion and [10,11,13] has been sporadically reported to treat HA embolism-induced skin necrosis [14][15][16][17], however, well-designed case-control studies are required to verify the efficacy and safety of hyaluronidase before it can be used routinely in humans.…”

Dermal Fibroblast Cells: Biology and Function in Skin Regeneration

“…These outstanding features highlight the importance of cell therapy. Researchers in medical sciences believe that use of cell therapy, along with gene therapy, can influence the occurrence of diseases in the future (1,2).…”

Ischemical Problems after Filler Injections: Anatomical Details and Practical Guide Lines to Avoid Disasters

“…More caution has to be taken in patients with a history of bee allergy because hyaluronidase is considered to be one of the active components in bee venom [27][28][29][30][31][32][33][34][35][36][37][38][39][40]. There are no reported anaphylactic reactions after subepidermal injections [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44].…”