Rare But Serious Necrosis Risks Follow Hyaluronic Acid Cosmetic Injections, Warn Tel Aviv Doctors

Hyaluronic acid injections, widely used for aesthetic treatments like wrinkle filling and lip shaping, can in rare cases cause severe tissue necrosis, according to specialists at Tel Aviv's Ichilov Medical Center. This complication arises when the filler blocks blood supply to facial tissues, potentially resulting in permanent scarring, facial deformities, and in very rare instances, vision impairment.

Doctors at Ichilov report weekly cases of patients arriving with suspected or confirmed necrosis following cosmetic injections. Rapid diagnosis and treatment are critical, as delays of even hours can determine whether tissue damage is reversible. Patients describe sudden pain, skin color changes, and swelling shortly after routine procedures, sometimes escalating to blistering and tissue death requiring surgical intervention and hospitalization.

Dr. Sivan Mercer, an expert in aesthetic dermatology at Ichilov, highlights the nose, lips, and nasolabial folds as the most vulnerable areas. She notes that while Botox does not cause vascular blockages, hyaluronic acid fillers can. In extremely rare cases, filler material can enter ocular arteries, causing vision problems. One recent case involved a woman who developed extensive necrosis affecting facial and oral tissues, necessitating intensive care.

Dr. Ari Sapir, a senior dermatologist at Ichilov, estimates the risk of necrosis at about one in 6,000 procedures. Early warning signs include unusual pain, skin whitening, redness, numbness, and blister formation. Prompt medical attention significantly improves outcomes, but some patients still suffer lasting scars or deformities. Mercer stresses that complications can occur even with skilled practitioners and proper clinical settings, underscoring the importance of immediate recognition and treatment.

Patients are urged to seek urgent care if they experience abnormal symptoms after injections. The medical teams emphasize that while these adverse events are rare, awareness and swift response are essential to prevent permanent damage.