Secretome-Assisted Regenerative Therapy for Hyaluronic Acid Filler-Induced Vascular Occlusion: A Case Report

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Hyaluronic acid (HA) fillers are widely used for non-surgical facial contouring, but vascular occlusion remains one of the most feared complications due to its potential to cause necrosis, functional impairment, and permanent deformities. Conventional management focuses on high-dose hyaluronidase and supportive therapy, which may not always prevent long-term sequelae. In recent years, regenerative approaches such as secretome and mesenchymal stem cell (MSC) therapies have emerged as promising alternatives. We report the case of a 29-year-old woman who developed nasal vascular occlusion following HA filler injection by a non-medical injector. Initial presentation included localized pain and cutaneous necrosis in the nasal tip. Early management involved repeated hyaluronidase infiltration, oral sildenafil, a single dose of prednisone, and adjuvant intravenous peroxidation therapy. Subsequently, 12 local applications of standardized MSC-derived secretome were administered. This strategy promoted granulation tissue formation, re-epithelialization, and partial recovery of skin integrity. However, clinical persistence of nasal asymmetry suggested cartilage involvement. To address this, an additional injection of 10 million MSCs was performed, leading to stable cutaneous coverage and improvement of nasal contour within 45 days. At the two-year follow-up, the patient showed a stable sc

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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