An out-of-season cold. Filler-induced vascular occlusion of the columellar artery causing necrosis of the cartilaginous anterior nasal septum: case report and a literature review

Hyaluronic acid fillers are widely employed for aesthetic procedures but can lead to vascular complications, including rare instances of arterial occlusion. We report a case of columellar artery occlusion following a nasal filler injection in a 30-year-old woman. The patient initially presented with subtle symptoms, including persistent rhinorrhoea and an unusual sensation of cold air. Rhinoscopy revealed full-thickness necrosis of the anterior nasal septum, likely due to compression or embolization of the septal branch of the superior labial artery; prompt treatment with hyaluronidase, aspirin, and topical antibiotics resulted in complete resolution. A literature review identified only one similar case, emphasizing this complication’s rarity and potential underreporting. This case underscores the importance of early recognition and intervention in filler-induced vascular events.