Complicanze da Filler - Occlusione Vascolare
Complicanze da Filler - Occlusione Vascolare



As the name suggests, Vascular occlusion occurs when the filler accidentally enters the lumen of the artery, causing it to become occluded and disrupting normal blood flow.


The symptomatology is not always the same, because it depends on the type of vessel involved and the degree of the occlusion. However, the two main signs of arterial vascular occlusion are:

  • Severe sharp pain
  • Changes in skin color: Immediate and prolonged whitening of the skin with a bruised appearance of the surrounding areas


This complication must be treated immediately.
interrupt the procedure with the filler
The main objective is to restore correct blood flow to the affected area
The protocol includes:

topical warm compresses (promotes vasodilation)

topical nitroglycerin (1 or 2%) in cream or sublingual tablets (alternatively sildenafil tablets can be used)

Hyaluronidase injection (high doses of hyaluronidase are required to be repeated with pre-established cycles until complete clinical resolution)

Oral antibiotic and corticosteroid therapy

Acetylsalicylic acid tablets

low molecular weight heparin

Chamber cycles with hyperbaric oxygen

The occlusion of the retinal artery 

Retinal artery occlusion is an ocular emergency that deserves special attention because, even if it occurs very rarely, it is very dangerous. It can occur after an aesthetic procedure with tissue fillers, such as autologous fat or hyaluronic acid fillers or other substances.
The areas of the face where the product is injected that are most at risk are:
The glabella (38.8%)
The nasal region (25.5%)
The nasolabial folds 13.3%)
The forehead (12.2% )
Regarding the type of filler, the most common cause is the injection of autologous fat (47.9%) followed by hyaluronic acid (23.5%).
The first symptom the person experiences is blindness in the affected eye, usually painless, which can occur within seconds of being injected. Other symptoms are pain in the affected area and headache. The first thing to do with a patient who presents this complication is to refer him to a specialized ophthalmology center because if this condition persists for more than 60-90 minutes it becomes irreversible.

In the context of arterial occlusion, if this is not treated immediately, it can lead the affected area of ​​tissue to:



Necrosis is the cellular death of the tissue, for this reason it is important that the professional knows and recognizes all the signs of skin necrosis and any related therapy. This type of complication can occur in any area of ​​the body but the areas “most at risk” are those in which the blood supply depends above all on a single arterial branch (nose area and nasolabial folds).
The first symptoms of necrosis are pain at the injection site and blanching of the area (no blood flow) so immediate action is required if these symptoms are recognized.



Venous compression occurs when the filler is placed so close to a vein that it is squeezed from the outside. This compression prevents the normal outflow of blood.


The two main symptoms of venous compression are:

  • Area pain
  • Changes in skin color: immediate and prolonged bluish color of the area


Even though venous compression is less severe than arterial compression, it should be treated immediately.

  • immediately stop the procedure with the filler
  • Injection of hyaluronidase in the affected area and surrounding areas
  • Topical warm compresses
  • Topical Nitroglycerin 2% (to promote vasodilation)
  • therapy with corticosteroids and oral antibiotics

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       occlusione arteriosa