From the Research
The risk of vascular occlusion with Restylane filler is a serious but rare complication, occurring in approximately 0.001% to 0.05% of cases, and immediate treatment with hyaluronidase is crucial to prevent long-term damage. Vascular occlusion happens when filler material is accidentally injected into or compresses a blood vessel, blocking blood flow to surrounding tissues. This can lead to tissue necrosis (death), particularly in high-risk areas such as the glabella (between eyebrows), nasal ala, and nasolabial folds. Early signs of vascular occlusion include immediate blanching, followed by pain, mottled bluish discoloration, and later tissue necrosis if untreated.
Key Points to Consider
- The use of small amounts of filler with slow injection technique can reduce the risk of vascular occlusion 1.
- Aspiration before injection and thorough knowledge of facial anatomy are also essential in minimizing the risk of vascular complications 2.
- Having hyaluronidase immediately available during all procedures is crucial in case of an emergency 3.
- Additional treatments may include aspirin (325mg), topical nitroglycerin paste, and potentially hyperbaric oxygen therapy 4.
- The importance of a preventive approach to avoid such catastrophic complications cannot be overstated, as highlighted in a case report of unilateral vision loss after hyaluronic acid injection 5.
Treatment Approach
If vascular occlusion is suspected, treatment should be immediate and includes:
- Stopping the injection
- Applying warm compresses
- Massaging the area
- Injecting hyaluronidase (typically 150-300 units) to dissolve the hyaluronic acid filler Practitioners should be aware of the potential risks associated with fillers and promptly address any adverse effects to achieve optimal clinical outcomes.