Kate Kleydman1, Joel L Cohen, Ellen Marmur. 1. Division of Dermatologic and Cosmetic Surgery, Department of Dermatology, Mount Sinai Medical Center, 5 East 98th Street, New York, NY 10029, USA.
Abstract
BACKGROUND: Skin necrosis after soft tissue augmentation with dermal fillers is a rare but potentially severe complication. Nitroglycerin paste may be an important treatment option for dermal and epidermal ischemia in cosmetic surgery. OBJECTIVES: To summarize the knowledge about nitroglycerin paste in cosmetic surgery and to understand its current use in the treatment of vascular compromise after soft tissue augmentation. To review the mechanism of action of nitroglycerin, examine its utility in the dermal vasculature in the setting of dermal filler-induced ischemia, and describe the facial anatomy danger zones in order to avoid vascular injury. METHODS: A literature review was conducted to examine the mechanism of action of nitroglycerin, and a treatment algorithm was proposed from clinical observations to define strategies for impending facial necrosis after filler injection. RESULTS AND CONCLUSIONS: Our experience with nitroglycerin paste and our review of the medical literature supports the use of nitroglycerin paste on the skin to help improve flow in the dermal vasculature because of its vasodilatory effect on small-caliber arterioles.
BACKGROUND: Skin necrosis after soft tissue augmentation with dermal fillers is a rare but potentially severe complication. Nitroglycerin paste may be an important treatment option for dermal and epidermal ischemia in cosmetic surgery. OBJECTIVES: To summarize the knowledge about nitroglycerin paste in cosmetic surgery and to understand its current use in the treatment of vascular compromise after soft tissue augmentation. To review the mechanism of action of nitroglycerin, examine its utility in the dermal vasculature in the setting of dermal filler-induced ischemia, and describe the facial anatomy danger zones in order to avoid vascular injury. METHODS: A literature review was conducted to examine the mechanism of action of nitroglycerin, and a treatment algorithm was proposed from clinical observations to define strategies for impending facial necrosis after filler injection. RESULTS AND CONCLUSIONS: Our experience with nitroglycerin paste and our review of the medical literature supports the use of nitroglycerin paste on the skin to help improve flow in the dermal vasculature because of its vasodilatory effect on small-caliber arterioles.
Authors: Bruna Souza Felix Bravo; Laila Klotz De Almeida Balassiano; Camila Roos Mariano Da Rocha; Carolina Barbosa De Sousa Padilha; Carolina Martinezt Torrado; Roberta Teixeira Da Silva; João Carlos Regazzi Avelleira Journal: J Clin Aesthet Dermatol Date: 2015-12
Authors: Fernando Urdiales-Gálvez; Nuria Escoda Delgado; Vitor Figueiredo; José V Lajo-Plaza; Mar Mira; Antonio Moreno; Francisco Ortíz-Martí; Rosa Del Rio-Reyes; Nazaret Romero-Álvarez; Sofía Ruiz Del Cueto; María A Segurado; Cristina Villanueva Rebenaque Journal: Aesthetic Plast Surg Date: 2018-01-05 Impact factor: 2.326