fig2

Figure 2. A 38-year old female developed pain, redness and swelling of the left cheek hours after Radiesse injection to the zygoma for midface augmentation. She came to our care two days later. Note the erythema and dusky appearance to the skin in the distribution of the infraorbital artery and facial artery. The patient developed pustules and sloughing the following day. She was treated with aspirin, topical nitroglycerin, oral prednisone, intradermal sodium thiosulfate, hyperbaric oxygen and manual debridement with gradual improvement in tissue perfusion over two weeks and minimal scar tissue buildup