Dr. Sabuhi Abilov in collaboration with Dr. Carlos Aznar talk through the treatment protocol for a patient with nasal apex necrosis

A patient with a non-chirurgical procedure of 1ml Crosslinked hyaluronic acid on the 6th May 2019 presented with a vascular complication on the nasal apex. On her first visit, on the 13th May 2019, she was diagnosed with nasal apex necrosis.

Product

SIMILDIET™ Xtra Skin Repair vials are a powerful synchroniser of the skin’s natural restoration mechanisms. Its components regenerate skin by means of active ingredients that regenerate collagen and elastin fibres, enhancing the creation of structural dermal bridges that help restore damaged skin. They restore hydrolipidic structure promoting cell mitosis, reactivate vascular and lymphatic activity and provide antioxidants that help eliminate toxic intracellular substances. Cell regeneration process and collagen and elastin fibre production make possible stabilisation over time through fibroblasts and microcirculation reactivation.

Asian Centella, with a powerful healing effect, stimulates connective tissue cells increasing their fibrillar content. Organic silicon boosts and stimulates fibroblast proliferation. Rutin strengthens capillary resistance and decreases permeability. Hyaluronic acid is used as a substitute for collagen to stimulate fibroblasts used in collagen synthesis and to restore damaged structural bridges, besides its liquid retention capacity. Alaria esculenta extract stimulates the production of collagen III, IV and VII, strengthens the hydrolipidic barrier and stimulates the synthesis of matrix and perimembranous proteoglycans, glycosaminoglycans and hyaluronic acid. Tetrapeptide-7 enhances papillary dermal fibres network reconstruction, and tripeptide-30 inhibits extracellular matrix components degradation, decreases dermal tension and favours skin healing.

“Asian Centella, with a powerful healing effect, stimulates connective tissue cells increasing their fibrillar content.”

Technique

The treatment of the problem was performed in 9 sessions during the month of May 2019.

To treat the complication, we decided to first dissolve the crosslinked hyaluronic acid that had been injected in the nasal apex and to inhibit the inflammatory process.

For this purpose, during the first session, we decided to solve the injected hyaluronic acid on the nasal apex and inhibit the inflammatory process. We applied 1500IU Hyaluronidase diluted with 2ml of 0.9% NaCl solution and added to the solution 0.2ml of Dexamethasone 4mg/ml solution. The total solution applied: 2.2ml.

During the following sessions, we worked on stimulating the regenerative process of tissue surrounding the necrosed area, employing for this purpose a powerful synchroniser that restores skin, SIMILDIET™ Xtra Skin Repair vials, in combination with PRP, applying the resulting solution on the superficial intradermal buffy coat of the perilesional area.

Figure 2 (A) third session 15 May 2019, (B) fourth session 16 May 2019
Figure 1 (A) first session 13 May 2019, (B) second session 14 May 2019

To reduce oxidative stress, we applied Human Albumin 50mg/ml (Octapharma Productions GmbH).

Finally, the patient was recommended daily hyperbaric chamber sessions.

Treatment protocol:

  • 1st session: hyaluronic acid solution.
  • 2nd session: PRP on buffy coat + Xtra Skin Repair vials 1.5ml.
  • 3rd session: Human Albumin 50mg/ml 1ml + Xtra Skin Repair vials 1ml.
  • 4th session: PRP on buffy coat + Xtra Skin Repair vials 1ml.
  • 5th session: PRP on buffy coat + Xtra Skin Repair vials 1ml.
  • 6th session: Human Albumin 50mg/ml 1ml + Xtra Skin Repair vials 1ml.
  • 7th session: Human Albumin 50mg/ml 1ml + Xtra Skin Repair vials 1ml.
  • 8th session: Xtra Skin Repair vials 1.5ml.
  • 9th session: Xtra Skin Repair vials 1.5ml.

Figure 3 (A) fifth session 21 May 2019, (B) sixth session 23 May 2019

Figure 4 (A) seventh session 25 May 2019, (B) eighth session 27 May 2019
Figure 5 (A) ninth session 31 May 2019, (B) final result

Outcome

The treatment outcome can be seen in Figure 5, where a complete regeneration and healing of the area is easily observed.

Conclusions

The treatment outcome shows the powerful skin regenerating and healing effect of SIMILDIET™ Xtra Skin Repair vials.  
Find out more at: simildiet.com/EN/Xtra.html