As the indications and the cases of filler injections increase, the number of complications reported is also rising rapidly. One of the most severe adverse effects is skin necrosis. The most vulnerable areas are those with a single arterial supply. A 44-year-old and a 32-year-old female patients visited our clinic with dusky red necrotic tissue and numerous pustules on the noses after the filler injection to the nasal tip. Initially, we injected hyaluronidase to remove the remnant filler materials. Then, we extracted pustules gently after KMnO4 soaking, applied hyperbaric oxygen therapy, irradiated 833-nm LED, and put occlusive dressing with topical antibiotics and hyaluronic acid gel. They were prescribed vasodilators, aspirin, antibiotics, and antihistamine for 1 week. Both patients showed improvement, as the range of skin necrosis became smaller and the hue changed to dimmer reddish color. After the acute period, we used vascular laser to eliminate the redness and pneumatic injector to reduce the scar tissue. By sharing our experience in treating a number of patients with necrotic complication, we suggest a step-wise guidance on the emergency management and afterward treatment.