Understanding Vascular Complications Arising From Dermal Filler Injection

Abstract

Soft tissue fillers are widely used in cosmetic procedures but carry inherent risks, especially vascular complications like tissue necrosis and vision loss due to retinal ischemia. Recent filler advancements beyond hyaluronic acid increase the risk of intravascular invasion during injections. Tissue necrosis follows distinct stages: initial blanching, skin mottling from tissue ischemia, discoloration, and possible necrosis. Direct injection into arteries or high-pressure techniques can cause embolisms, a significant cause of tissue necrosis. Vision loss occurs when critical arteries get blocked, leading to retinal or optic nerve ischemia. Studies show that even tiny filler amounts injected into specific arteries can result in blindness, challenging the idea of using smaller volumes in high-risk zones. While using cannulas for injections offers some advantages, it comes with risks. Hence, practitioners need to adopt meticulous injection techniques. An in-depth understanding of filler phases and potential vascular complications is crucial for ensuring practitioner safety and patient well-being during cosmetic procedures. This knowledge forms the basis for minimizing risks associated with filler injections.