In 2020, after six years of aesthetic practice, I caused my first vascular occlusion (VO) during a hyaluronic acid dermal filler treatment. I had planned to address multiple facial areas, with the goal of achieving a rejuvenated, fresh-faced look.
I began by treating both the patient’s temples with a needle to periosteum approach, 1cm along and down from the temporal fusion line (aspirations were negative). Following this, I wanted to create more seamless transitions, so used a cannula, entering over the zygoma to treat the lateral orbital fat compartment. Aspirations with a 25 gauge cannula were all negative too.
The whole treated area looked perfect, with normal skin colouration and my patient was comfortable throughout. It was only as I retracted my cannula to remove it that an immediate swelling appeared just lateral to the tail of the brow, which I recognised to be a haematoma. I…
