What is a Vascular Occlusion?
Vascular Occlusions: What You Need to Know
We love dermal fillers just as much as you do! Dermal fillers are a great treatment option to restore lost volume due to aging, enhance your natural features and create contour. While most cosmetic procedures are very safe, understanding the potential risks, like vascular occlusions, is vital for both practitioners and patients.
What Are Vascular Occlusions?
A vascular occlusion refers to the blockage or obstruction of blood flow within a blood vessel. It is one of the most undesired (and most rare) outcomes of injectable dermal filler.
Injection-related Causes of Vascular Occlusions
Vascular occlusions can occur when the practitioner inadvertently injects filler into a blood vessel, leading to a blockage and potential complications. Though it is a very rare occurrence, it can cause many unwanted side effects that range from mild to severe.
Signs and Symptoms
What are the signs and symptoms of vascular occlusions? The signs and symptoms of vascular occlusions can vary depending on the location and severity of the blockage. Common signs of a vascular occlusion include:
Paleness or discolouration of the skin
Persistent pain or discomfort
Swelling or edema (fluid build-up) in the affected area
Decreased or absent pulse
Skin that feels cool to the touch
Numbness or tingling sensations
Tissue Necrosis
In very severe cases, vascular occlusion can lead to tissue necrosis (tissue death) if it is left untreated for too long. A vascular occlusion will significantly reduce or entirely block blood flow from circulating the surrounding tissue, depriving the tissue of oxygen and essential nutrients carried by the blood. When the tissues are deprived of oxygen and nutrients for an extended period, they begin to undergo irreversible damage, ultimately resulting in necrosis.
Blindness
A vascular occlusion can also lead to potential blindness. Though vascular occlusions are a potential risk for any treatment area, it is most common when treating the under eye or nose. Why? These areas are close to the glabella region (the skin on the forehead, between the eyebrows and nose). This is a riskier area to inject with dermal filler compared to others due to the high quantity of blood vessels.
A vascular occlusion within the ophthalmic artery (the artery that supplies blood and oxygen to the eyes) or its branches, will result in significantly reduced or entirely blocked blood flow to the optic nerve. Reduced blood flow deprives the optic nerve of oxygen and nutrients, resulting in damage to the nerve fibers. Prolonged oxygen deprivation to the optic nerve will result in irreversible damage to the injury to the nerve fibers. Damage to the optic nerve partial or complete blindness.
Prompt recognition and management of vascular occlusions are essential to minimize risk and mitigate potential complications.
Preventive Measures
While vascular occlusions can present significant risks, several preventive measures can help minimize their occurrence:
Proper training: Healthcare professionals performing cosmetic procedures should undergo comprehensive training to minimize the risk of vascular occlusions, recognize the signs and symptoms, and manage complications promptly and effectively.
Patient assessment: Thoroughly evaluate patients for any pre-existing medical conditions, allergies, or contraindications that may increase the risk of vascular occlusions.
Hygiene and sterilization: Strict adherence to hygiene protocols and proper sterilization of equipment can prevent infections that may lead to vascular occlusions.
Injection technique: Employing proper injection techniques, including aspiration to check for blood return before injecting, can help prevent inadvertent injection into blood vessels.
Understanding vascular occlusions is crucial for both treatment providers and patients involved in cosmetic procedures. By being aware of the potential risks, implementing preventive measures, and promptly addressing any complications that arise, we can ensure safer and more effective treatments in the field of medical aesthetics.