Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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Forehead reconstruction using modified double-opposing rotation-advancement flaps for severe skin necrosis after filler injection

  • Kim, Jinwoo (Department of Plastic and Reconstructive Surgery, Busan Paik Hospital, Inje University School of Medicine) ;
  • Hwang, Woosuk (Department of Plastic and Reconstructive Surgery, Busan Paik Hospital, Inje University School of Medicine)
  • Received : 2017.11.09
  • Accepted : 2018.03.08
  • Published : 2018.03.31
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Abstract

Varying degrees of complications can occur after hyaluronic acid filler injections. Tissue necrosis due to interruption of the vascular supply is an early complication that can be severe. If the site of tissue necrosis due to the filler injection is the forehead, successfully reconstructing the region without distorting the key landmarks is challenging. We describe the case of a 50-year-old man who experienced widespread forehead skin necrosis after hyaluronic acid filler injection in the glabellar area. We successfully covered the forehead area with a $3{\times}4-cm^2$ midline necrotic tissue using the modified double-opposing rotation-advancement flap method. Although modified double-opposing rotation-advancement flap closure has the disadvantage of leaving a longer scar compared to conventional double-opposing rotation-advancement flap closure, the additional incision line made along the superior border of the eyebrow aids in camouflaging the scar and decreases eyebrow distortion. Therefore, it is believed that the modified double-opposing rotation-advancement flap technique is an excellent tool for providing adequate soft tissue coverage and minimal free margin distortion when reconstructing widespread skin necrosis in the central mid-lower forehead that can occur after filler injection in the glabellar area.

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References

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  2. Vascular Complication in Aesthetic Medicine Treated with Hyperbaric Oxygenation vol.63, pp.2, 2018, https://doi.org/10.2478/phr-2018-0010