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Vascular occlusion occurs when blood is inhibited from it’s normal flow due to a blockage of the vessel. These can appear as either a complete or partial occlusion, depending on where the cause of the block is located. When blood flow is diminished, the surrounding tissue is no longer being fed nutrients from the blood, and begins to die. These emergencies have been cited as one of the most feared and severe early complications in aesthetic treatment. The two areas where vascular occlusions are more at risk is in between your eyebrows and your nose. Vascular complications can happen after injection by even the most experienced and qualified injectors. Be sure to lean towards products that are dissolvable, as not all of them are. While there are guidelines for best practice to work towards prevention, in many cases occlusions are a matter of if and not when.

What are the dangers? 

If vascular occlusions are left untreated it can lead to skin necrosis, blindness, and in some cases cause a stroke. When the product is located in or against a vessel that is connected to the eye, blindness can occur. There is a short grace period for reversing blindness, and if not treated quickly and correctly, can be permanent. Necrosis is death of the tissue due to lack of oxygen from the blood vessels. 

How do you know if there’s been an occlusion? 

Let’s talk about common signs and symptoms. First of all, if any pain is experienced after treatment, that is not always normal. This side effect may not be noticeable until all numbing has worn off. If there is pain in areas that are not numb, this is a sign. If the surrounding skin appears to be losing its normal color, ie. turning white (blanching) or purple, that is a good indication of a complication. The skin can turn hues of purple and red which may mimic a bruise, however when this is paired with other symptoms, it is very severe. Patients should always be informed to make their injector aware of any possible signs. Some studies show that people with blood flow issues (diabetes, high cholesterol and high blood pressure) do have a higher risk of this happening.

Dear Injectors, Community is key.

Community is so important, especially in our profession.  As a medical injector, best practice is considered to have at least 14 bottles of Hylenex on hand, and more importantly: be trained on how to use it to fix this type of emergency. One woman needed 64 bottles due to how severe her vascular occlusion was, and because her injector knew other colleagues in her area, she was able to pull together enough medication to reverse the intense compilation. Make sure to talk with other professionals not only in your community, but your neighboring areas as well. You never know when you could have this medical emergency, and you want to be prepared. 

medical emergency, and you want to be prepared.

How can I fix it? 

Practicing safe techniques to prevent complications is top priority for anyone injecting dermal fillers. Research has proven Hyalenex to be an important piece of the puzzle when it comes to dissolving and dispersing some injectable fillers. More importantly, the best way to prepare yourself for a vascular emergency is to take a training, and keep yourself updated on education pieces geared toward this subject. Like Yvonne Dellos, FNP always says “If you don’t know how to fix the complication to the procedure you’re performing, perhaps you shouldn’t be performing the procedure in the first place.”

Our Aesthetic ER training is launching mid September, and pre-registration is available now.

This course will include a kit, allowing you to feel prepared at all times with the tools and medications needed to save a patient in the event of a vascular occlusion. As this is the first training and kit of it’s kind in the industry, it will be a big game changer in the Aesthetic world. These kits will be the answer  the prayers of any injector who encounters a vascular occlusion.




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