What happens if filler is injected into an artery?

The most severe potential complication associated with the use of dermal fillers and volume enhancers is arterial/venous occlusion, which leads to ischemia, with subsequent necrosis of the skin and/or vision loss. These events are considered a medical emergency and must be dealt with immediately.

What does an occlusion from filler look like?

A) Vascular occlusion usually causes some pain or discomfort, but may only manifest itself by the appearance of blanching, bluish discoloration, or mottling of the skin. Anything that seems unusual even hours after dermal filler injection should be reported immediately to your treatment provider.

What causes vascular occlusion with fillers?

Vascular occlusion is caused by an accidental injection of filler into an artery. This results in a blockage of circulation in oxygen and nutrients to cells in the area. Experts concur that compression can also be a cause.

How can you prevent vascular occlusion with fillers?

Preventing Filler Embolus and Vascular Occlusion

1. Know your anatomy.
2. Aspirate.
3. Inject small volumes.
4. Inject slowly.
5. Consider cannula use.
6. Beware previous scarring or surgery.
7. Product choice.
8. Progress appropriately!

Where should you not inject filler?

Top 5 Danger Injection Zones for Dermal Fillers

• Between the eyebrows and just above the nose. It is recommended that you use a Low-G filler around this region using the serial puncture technique.
• Temple area.
• Lines between the corner of nose and the mouth.
• Infraorbital region.
• Nasal Augmentation.

Where should you not inject fillers?

Danger Zones 1 and 2: Supraorbital and Supratrochlear Arteries in Glabella. In the upper corner and at mid pupillary along the supra orbital rim there are two sets of arteries: the supratrochlear and the supraorbital arteries. Both sets of arteries are small and have little to no collateral circulation.

Is Blindness from fillers immediate?

Visual loss following embolization of dermal filler typically occurs within seconds of injection,7 although visual loss has been reported seven hours post-treatment in the case of a posterior ciliary artery occlusion. Complete loss of vision is the normal presentation, although there might be visual field defects.

What are the signs of a vascular occlusion?

The two primary diagnostic symptoms of vascular occlusion are pain and changes in skin color. Immediate, severe, and disproportionate pain and acute onset of color changes – blanching (or white spots/blotches) – are an indication of arterial occlusion.

How do you get rid of vascular occlusion?

TREATMENT OF VASCULAR OCCLUSION

1. Immediately stop treatment.
2. Assess capillary refill time (CRT).
3. Firmly massage the area.
4. Apply heat.
5. Tap the area.
6. Inject with hyaluronidase.
7. Aspirin.
8. Antibiotics.

How long after filler does vascular occlusion occur?

Pain is usually associate with vascular occlusion. There have been cases reported that occurred 12-24 hours after being injected but almost always it occurs immediately.

How common is vascular occlusion with fillers?

Findings In this cohort study of 370 participating dermatologists, the risk of vascular occlusion appears exceedingly low (1 in 6410 syringes via needle and 1 in 40 882 via microcannula injector) when board-certified dermatologists inject skin fillers with needles or cannulas.

Who shouldnt get fillers?

10. There are some times you shouldn’t get fillers injected. Though fillers are considered safe, there are a few reasons to postpone an injection. If you’re pregnant, breastfeeding, or you’re battling a sinus infection, it’s best to hold off, as any infection in the facial area could spread to the injection site.

Can a dermal filler cause vascular occlusion?

Dr Tim Pearce has been practicing medical aesthetics for over 10 years, and in April 2018, he experienced his first vascular occlusion when injecting the dermal filler. This article has been taken from the A True Story: Emergency Reversal of Filler interview with Dr Adam Cheong on the Aesthetics Mastery podcast (found on iTunes and Soundcloud).

What are the side effects of dermal filler injections?

In the U.S. over 2.6 million dermal filler injection treatments in 2017. It is imperative that we as medical providers to keep patients safe. Bruising, tenderness and swelling after having dermal fillers is expected. Direct Vessel occlusion or non-direct vessel constriction are very serious complications.

Can a dermal filler injection cause a pulmonary embolism?

The middle temporal vein drains into the jugular and can cause a distal pulmonary embolism if injected with dermal filler. Use vessel mapping, locate arterial pulse, aspirate, avoid large high pressure bolus.

How to book in for emergency reversal of vascular occlusion?

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