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Know The Risks! What you need to know about the dangers of a vascular occlusion following dermal fillers and how you can keep yourself safe
D
ermal fillers can be extremely safe and effective treatments in the right hands. They can help to lift and smooth lines, replace volume loss and enhance and beautify certain areas of the face and body. However, the injectable gel can also cause side effects. We’re sure you’ve seen the most dangerous dermal filler side effect commonly covered in the media – a vascular occlusion (VO). Although the majority of dermal filler treatments performed by a skilled and highly trained medical practitioner do not have complications, it’s important to be aware of this risk before having the treatment. To get the lowdown on the risks of VOs following dermal filler treatments and to find out what you can do to help prevent this happening to you, we spoke to Dr Martyn King, chair of the Aesthetic Complications Expert (ACE) Group World, an association that aims to diagnose, manage and prevent complications in aesthetic medicine.
What is a vascular occlusion?
Dr Martyn King, aesthetic practitioner, Cosmedic Skin Clinic, Tamworth IG: @cosmedic_clinic
Vascular occlusion refers to the blockage of a blood vessel, which stops blood from being able to travel. There are two types of VO: partial – when some blood is able to pass through the vessel – or complete – where the vessel is completely clogged resulting in the absence of blood flow. If the blood supply to the skin and surrounding tissue is impaired in any way, the result is a lack of oxygen and other essential nutrients to the area. This may severely impact the health of your cells and may lead to death of the tissue (necrosis), ulceration, infection and permanent scarring. This is why a VO can cause a very distressing appearance for patients as well as pain and other signs and symptoms. In the rarest occurrence, a VO may even pass into the blood vessels supplying the eye resulting in vision disturbance and even blindness!
How a blood vessel can become blocked due to dermal fillers
Normal blood flow
Partial blocked vessel due to dermal filler
Complete blocked vessel due to direct dermal filler placement
How is a vascular occlusion caused?
A foreign substance such as an injectable dermal filler may block a blood vessel by being injected directly into it. Dermal filler can also cause a VO if it is injected very close to the wall of the blood vessel, compressing or ‘kinking’ it (check out the image). Although VOs might occur precisely where the dermal filler is injected, they can also happen at a different location as the filler can travel along the blood vessel where it will eventually reach a narrower point and get stuck – this is known as embolisation.
How common are vascular occlusions?
Thankfully, VOs are a rare complication of dermal filler treatments, with an incidence of 1 to 10 cases per 100,000 treatments (0.001% to 0.01% risk). However, due to the increasing number of treatments being performed in the UK, the ACE Group World help to manage two to three cases of VO each week. Most of these are reported to have been caused by non-medical professionals. Indeed, out of 28
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Complete blocked vessel - dermal filler compression
