Rare But Serious Necrosis Risks Highlighted in Popular Hyaluronic Acid Aesthetic Treatments

Hyaluronic acid injections, widely used for cosmetic purposes such as wrinkle filling and lip shaping, can in rare cases cause dangerous tissue necrosis, according to specialists at Ichilov Medical Center. This severe complication arises when the filler blocks blood supply to facial tissues, potentially leading to permanent scarring, facial deformities, and in very rare instances, vision impairment.

At Ichilov's dedicated complications clinic, doctors report nearly weekly cases of patients presenting with necrosis or suspected vascular compromise following aesthetic injections. Prompt recognition and treatment are critical, as the difference between full recovery and lasting damage can be a matter of hours. Patients like Hadar, 48, and Noam have shared harrowing experiences of escalating pain, skin discoloration, and tissue damage after routine procedures, requiring hospitalization and surgical intervention.

Dr. Sivan Mercer, a dermatologist specializing in aesthetic and laser treatments at Ichilov, explains that the nose is among the most sensitive areas prone to such complications, with other common sites including lips and nasolabial folds. While botulinum toxin (Botox) does not cause vascular blockages, hyaluronic acid fillers can. In rare cases, filler material may reach eye arteries, causing vision problems, underscoring the need for immediate medical response.

Dr. Ari Sapir, a senior dermatologist at Ichilov, notes that necrosis occurs in about one in 6,000 cases and manifests initially as unusual pain, skin whitening, redness, or blistering. Early detection of these warning signs significantly improves outcomes. Treatments are more effective when patients seek help promptly, but delays can result in extensive tissue death requiring surgical removal.

Experts emphasize that complications can occur even with skilled practitioners and in proper clinical settings. The key difference lies in the ability to quickly identify and manage adverse events. Patients are urged to be vigilant for symptoms such as severe pain, color changes, numbness, or unusual skin appearance after injections and to seek urgent care to minimize permanent damage.