Understanding and Treating Filler Necrosis

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Vascular events following dermal filler injections, including occlusion and compromise, alongside the worst-case scenario of impending necrosis, are much-discussed complications in modern aesthetic practice. Better understanding and training, plus increased acknowledgement that they occur, means that practitioners must know how to manage accidental intra-arterial filler injections if they embark on a career in medical aesthetics.
The injection of any substance into the face for cosmetic enhancement creates a risk of blocking a blood vessel with a bolus of material and compromising circulation.1
Thankfully, these days, the specialty predominantly favours temporary, hyaluronic acid (HA) based products which are easily reversible using off-label hyaluronidase. Problems are often diagnosed and treated quickly, but is our understanding of the exact interaction between blood vessels and…

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