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Autologous fat grafting is a technique that has been used for a long time in the field of plastic surgery. Besides many advantages, the complications, which can range from mild such as hematoma, infection, calcification, necrosis... even death is a big problem.  The article presents a case of using autologous fat taken from the abdomen to graft onto the facial area with complications of severe infection in both the receiving and donor sites, causing necrosis of fat and skin in both areas. The treatment takes a long time with different procedures, but the consequences for the patient are still very serious both in terms of aesthetics and function. The objective of this study was to evaluate the safety and efficacy of fat grafting to the facial region for the reconstruction and aesthetic enhancement of facial contour.

and edited the article. V.N.L. and N.T.N. equally designed and conducted the experiment. N.Q.D. and V.N.L. studied scientific literature about the topic. All authors read and approved the final manuscript. This study complied with the Declaration of Helsinki in relation to medical research involving human subjects and got consent from the Research Ethics Committee of the 108 Institute of Clinical Medical and Pharmaceutical Sciences. Informed consent was obtained from all individual participants included in the study. All patients provided written consent for publication of their photographs and surgery outcomes.

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Background: Hyaluronic acid (HA) fillers for aesthetic are generally considered safe and the use of dermal fillers for soft tissue augmentation has become a very popular technique in aesthetic practices. Dermal fillers temporarily remove the appearance of rhytids and reduce the depth of skin folds. This is one of the most effective method for facial improvement used in Viet Nam nowadays.  However, complications such as skin necrosis, blind... may happen and hence any filler injection practitioner need to be aware of such side effects, contraindications and precaution to be adopted while using fillers. Even with the most experienced of injectors, adverse effects can and do occur ranging from mild bruising to severe injection necrosis. Aims: HA filler injectors should be able to prevent and treat the severe complication of skin necrosis and detect impending necrosis after injection of a augmentation filler. Materials and Methods: Cases report of 3 patients who were HA filler injection for nose augmentation and had suffered from skin necrosis. These patients were followed for 3-6 months from time of injection of hyaluronic acid filler to complete healing of wound. Results: Complete wound healing were achieved with early recognition and institution of treatment, surgical procedures applied in some severe cases. The functional of the noses are remained but  most of the patients have bad scar on the nose. Discussion: We review cases report of injection necrosis and methods used to prevent and treat this complication. Conclusion: Early recognition of vascular necrosis with specific protocol for treatment after injection necrosis with hyaluronic acid fillers improves the outcome of wound healing.