From the Research
Hyperbaric oxygen therapy (HBOT) should be considered as an adjunctive treatment for filler-associated arterial occlusion, particularly when standard treatments have failed to resolve the occlusion or when tissue necrosis is progressing, as evidenced by a recent case report in 2024 1. The role of HBOT in treating filler-associated arterial occlusion is to enhance oxygen delivery to ischemic tissues, reduce tissue edema, promote neovascularization, and potentially reduce inflammation.
- HBOT works by delivering 100% oxygen at pressures greater than atmospheric pressure (typically 2.0-2.5 atmospheres) in specialized chambers, which dramatically increases tissue oxygen levels.
- The typical protocol involves daily 90-120 minute sessions for 5-10 days, depending on clinical response, as seen in a case report from 2022 2.
- HBOT's mechanism of action is beneficial in reducing tissue damage and promoting healing, as reported in a study from 2019 3 and another from 2022 4.
- It's most effective when initiated within 24-48 hours of the occlusion event, although it can still be beneficial when started later, as shown in a case report from 2022 1.
- However, HBOT has limited availability, requires specialized facilities, and may be contraindicated in patients with certain conditions like untreated pneumothorax or severe claustrophobia.
- While promising as a salvage therapy, HBOT should not delay implementation of primary treatments for filler-associated vascular occlusion, such as hyaluronidase for hyaluronic acid fillers, warm compresses, nitroglycerin paste, aspirin, and potentially low-molecular-weight heparin, as suggested by a study from 2024 1.