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Skin Necrosis of the Nose After Injection of Ribose Cross-Linked Porcine Atelocollagen.

Abstract
We report a case of skin necrosis of the nasal tip after an injection of ribose cross-linked porcine atelocollagen (Evolence; Colbar Life Science Ltd, Herzliya, Israel). A 22-year-old woman had a nasal augmentation. From the glabella to the nasal tip, 10 strokes were injected using 0.6 mL of Evolence. On the day of the injection, her nasal tip became cyanotic; a day after it, an erythematous condition developed and a white cheeselike material appeared. On the second day, it became necrotic. Epithelialization was completed for 2 weeks. Despite laser therapy, permanent scarring of the nasal tip was prominent at the 18-month follow-up. It was thought that the skin necrosis is caused by vascular interruption rather than by hypersensitivity because the skin necrosis was confined to the nasal tip. To avoid vascular interruption from a filler injection, aspiration is needed before injection. The least amount of filler should be released in each stroke with low-pressure injection.
AuthorsSeong Kee Kim, Joo Ho Kim, Kun Hwang
JournalThe Journal of craniofacial surgery (J Craniofac Surg) Vol. 26 Issue 7 Pg. 2211-2 (Oct 2015) ISSN: 1536-3732 [Electronic] United States
PMID26468812 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Cross-Linking Reagents
  • Dermal Fillers
  • dermicol-P35 27G
  • Ribose
  • Collagen
Topics
  • Cicatrix (etiology, surgery)
  • Collagen (adverse effects, chemistry)
  • Cosmetic Techniques (adverse effects)
  • Cross-Linking Reagents (chemistry)
  • Cyanosis (etiology)
  • Dermal Fillers (adverse effects, chemistry)
  • Erythema (etiology)
  • Female
  • Follow-Up Studies
  • Humans
  • Injections (adverse effects)
  • Laser Therapy
  • Necrosis
  • Nose (pathology)
  • Re-Epithelialization (physiology)
  • Ribose (chemistry)
  • Skin (pathology)
  • Young Adult

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