Lin Pianpian, Zhou Guiwen, Li Guangdi, Wu Qian, Zhang Peixuan, Bai Ruiqi, Ding Hongfan, Fu Qiang, Xu Xiao, Chen Minliang
Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese, PLA General Hospital, Haidian District, No. 51 Fucheng Road, Beijing, 10048, People's Republic of China.
Department of Ophthalmology, The Third Medical Center of Chinese, PLA General Hospital, Beijing, People's Republic of China.
Aesthetic Plast Surg. 2025 Sep 29. doi: 10.1007/s00266-025-05184-1.
Vulvovaginal rejuvenation procedures are increasingly popular. Hyaluronic acid (HA) filler injection, a significant representative of non-surgical method, can cause a rare but serious complication: vascular embolism. Mild cases may present as skin necrosis and ulceration, while severe cases can be life-threatening.
The possible complications caused by vulvovaginal injection of hyaluronic acid were systematically reviewed. A 47-year-old Asian woman underwent a vulvovaginal rejuvenation procedure with HA fillers for labia majora, labia minora, and vaginal rejuvenation. She experienced a vascular occlusion event characterized by severe pain and necrotic skin ulceration. 7 days after the HA injection, she received superselective intra-arterial thrombolysis. Necrotic wounds were treated with CGF via topical application and local injection.
Three cases of vascular complications have been reported previously. This paper describes the fourth. After immediate intra-arterial thrombolytic therapy (IATT), angiography showed improved blood supply in the right internal pudendal artery. The patient's severe pain was relieved, and the necrosis was under control. The patient achieved complete wound healing within 5 days following CGF treatment and was subsequently discharged from the hospital.
Serious vascular embolic events can be caused by hyaluronic acid injection for vulvovaginal rejuvenation, which can be treated with superselective IATT. For wound repair resulting from compromised skin perfusion caused by HA injection, CGF therapy offers a viable alternative.
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外阴阴道年轻化手术越来越受欢迎。透明质酸（HA）填充剂注射作为非手术方法的重要代表，可引发一种罕见但严重的并发症：血管栓塞。轻症可能表现为皮肤坏死和溃疡，重症则可能危及生命。
系统回顾了外阴阴道注射透明质酸可能引起的并发症。一名47岁亚洲女性接受了用HA填充剂进行的外阴阴道年轻化手术，用于大阴唇、小阴唇及阴道年轻化。她经历了一次血管闭塞事件，表现为剧痛和坏死性皮肤溃疡。HA注射7天后，她接受了超选择性动脉内溶栓治疗。坏死伤口通过局部应用和局部注射CGF进行治疗。
此前已报道过3例血管并发症。本文描述了第4例。立即进行动脉内溶栓治疗（IATT）后，血管造影显示右侧阴部内动脉血供改善。患者的剧痛缓解，坏死得到控制。患者在接受CGF治疗后5天内伤口完全愈合，随后出院。
外阴阴道年轻化注射透明质酸可导致严重的血管栓塞事件，可通过超选择性IATT进行治疗。对于HA注射导致皮肤灌注受损引起的伤口修复，CGF治疗提供了一种可行的选择。
证据水平III：本刊要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266。
