Clinical appearance of vascular compromise after filler injection

Background: Although filler injections are established as safe and effective for facial rejuvenation, they have been associated with adverse outcomes. Vascular compromise is one of the most severe complications arising from facial filler injections, either as inadvertent intra-arterial embolization or vascular compression, which leads to localized skin necrosis or vision loss. Objective: This study aimed to estimate the clinical course and causes of vascular compromise after filler injections by conducting a retrospective analysis. Methods: We retrospectively analyzed 30 patients (28 females; mean age, 35.1 years; age range, 24-45 years) with vascular compromise in the nose after receiving filler injections between June 1, 2010 and June 30, 2015. All the patients began treatment of vascular compromise within 5 days after receiving filler injection. We retrospectively analyzed the patterns of filler necrosis by using medical photographs and records. Results: The pattern of vascular compromise followed the blood vessel distribution. As the vessels are connected to each other, they are difficult to classify clearly. However, they can be divided into lesions on the nasal bridge, nasal tip, nasal ala; lesions including more than 2 subunits; and lesions accompanied by surrounding structures such as the lips. In addition, the pattern and outcome of the lesions differed according to the cause, either arterial embolization or vascular compression. Conclusion: Vascular compromise resulting from filler injection can have serious consequences. As necrosis causes serious problems for both the patient and the physician, the possibility of necrosis must be recognized and prevented in advance, and immediate treatment should be performed when symptoms develop. KCI Citation Count: 0