Needling as a Potential and Novel Treatment for Skin Ischemia following Filler-Induced Vascular Occlusion: A Case Series.

Introduction: The most severe complication of filler injection is ischemia due to vascular occlusion, causing skin necrosis, scarring, blindness, and even stroke. Among the available treatments, needling therapy has been used in some clinical practices but has been rarely studied and discussed. Case Presentations: Four recent skin ischemia cases with subsequent needling procedure were observed retrospectively and pertinent literature was analyzed. The objective was to evaluate the efficacy and safety of needling procedure for filler-induced skin ischemia, which is unresponsive to standard therapies. Conclusion: All of the 4 cases recovered from skin ischemia without side effects by receiving needling procedure. The available data demonstrate some potential mechanisms of needling, such as embolus releasing, ischemia reperfusion and revascularization. Although there is a lack of conclusive evidence for improving the hypoperfusion area by needling treatment, the current cases observation and theoretical analysis as well as our cases provide evidence supporting its potential as an efficacious, simple, and secure treatment for vascular complications.