A vascular occlusion is a very rare occurrence when the dermal filler is injected into the blood vessel (artery or vein).  Essentially once the vessel is compromised or blocked it cannot supply blood to the surrounding tissue. The vascular system is complex,  everything is connected so a vascular occlusion can lead to severe secondary complications which can include tissue death (necrosis) scarring and deformity of the features, blindness, stroke & death.

This information is not designed to scare you it’s sole purpose is to alert you to these risks, by recognising the symptoms early so that you can alert your Practitioner,  they would rather be contacted even if you aren’t certain there is a problem.  

Will this happen to me

All procedures come with a degree of risk, your Practitioner will discuss your treatment in full and explain the risks.  You should ask questions, take time to understand the treatment and don’t allow yourself to feel pressured into treatment.  During the procedure your Practitioner will take certain steps to minimise the risks, such as aspiration of the syringe before injecting, wherever possible using a blunt tipped cannula rather than a needle.  Using the correct type of filler for the area is also important and again this reduces the risk. 

No procedure can be risk free, using a competent Medical Practitioner will ensure that they practice safely, will have the knowledge and skills to perform emergency treatment and will have access to other Medical Experts which can be critical in getting you the intervention to prevent permanent damage.


Following treatment and before you leave the clinic, your practitioner will perform  a capillary refill test and also observe any problem signs .  When the Practitioner is satisfied that the capillary refill test is normal.  If there are any concerns you may be asked to monitor and perform a capillary refill test at regular intervals and report back to them, you will be advised what to do by the Practitioner, this document will also provide a comprehensive guide.

The Practitioner may not have any concerns at the time of treatment, it is therefore important that you monitor closely the treatment area do not try to convince yourself that everything is ok or discuss concerns with friends or relatives, speak to your Practitioner, they will advise you, guide you and reassure you. Once you have left the clinic we rely on you to report anything unusual, time is of the essence, the faster you receive treatment in the event of a complication the less risk there is of more serious problems associated.


You may experience some or all of the symptoms;

  • Pain, you may not experience this immediately as the filler may contain local anaesthetic, the sensation after filler is usually a tight feeling, slightly tender and stiffness, if your are experiencing a pulsating sensation or throbbing pain, sometimes extreme pain may be experienced this is not normal and should be reported immediately.
  • The skin appearance, initially redness, the skin may look dusky, a bluish tint with a fine lace like pattern, if this is not treated promptly the skin will begin to break down due to the lack of blood supply, you will observe pustules the most superficial layers of the skin will slough off (peel away), you may also experience the skin breaking down from inside the mouth, ulcer like lesions (in the case of fillers close to the mouth or lip area), left untreated the skin will become necrotic (turn black and die). 


An obvious Vascular Occlusion (VO) like this one here will be immediately recognised and treated in clinic, the blanching (white area) is extensive and you can see just have much of the face is affected by the occlusion.  If this occurs during your treatment, the Practitioner will inform you, this is always an emergency and you cannot commence treatment without consent to emergency interventions.  Not all VO’s have evident signs, so it is vital you observe your face for any signs of problems.

Hyaluronidase will be injected around the site of the VO, this will dissolve the filler quickly, but depending upon the area and the filler you may require more than one treatment to resolve the problem, other treatments will be administered which will be discussed later.

Below you can find out more regarding the emergency treatment and a comprehensive guide to follow.


Following treatment bruising can occur and is very common,  Livedo (a fine lace like pattern) can easily be mistaken for a bruise.  This patterning maybe observed several minutes to several hours after treatment, and typically can last up to 36 hours.  This rash will track away from the treatment area as it is following the vascular system.  This is an indication that the tissue surrounding is not receiving oxygenated blood. 

The progression of the VO results in increased bluish tint from the restriction of blood supply to tissue, which can also be affected by temperature, without prompt treatment the skin will begin to break down.


After 36 hours the skin begins to break down and is becoming infected due to the lack of oxygen.  The skin is at risk from bacterial and or viral infections.  Once the skin has reached this stage, the possibility of irreversible damage is likely from scarring.

Never wait to report symptoms early intervention can prevent devastier permanent damage to the tissue, your safety is our primary concern and your Practitioner can be reached 24 hours a day.


Once the skin has reached this stage of necrosis. It is irreversible careful wound management can minimise the loss of tissue and prevent further scarring.

This is preventable with early intervention from your practitioner always REPORT, unusual, signs and symptoms,in a timely manner, your practitioner can be reached 24 hours a day,



Please remember your Practitioner would rather be contacted if you have any concerns, it is always better to be cautious.  Once you contact your Practitioner please describe your symptoms clearly…

  • Pain Severity Scale 1-10, 1 being mild pain & 10 being severe pain
  • Skin, describe how the skin looks, is there any discolouration ?
  • Loss of circulation, does the skin feel cold to touch ?
  • Do you feel unwell ?
  • Do you have redness, & heat at the site of injection ?
  • Any other concerns ?


Photographs should be taken with and without flash and should be clear, blurred photographs are of no use.

A video review may be required to assess the capillary refill which should be under 3 seconds, to undertake a capillary refill test.  Your Practitioner will instruct you to correctly to perform a capillary refill before you leave the clinic, see below for full instructions so you are prepared.


To undertake a capillary refill test you should stand in front of a mirror, in good light press firmly over the area for around 5 seconds when you release the pressure count the number of seconds before the colour is returned to the area.  This should be under 3 seconds, you may wish to perform capillary refill tests to both sides of the face to compare if appropriate.

Your Practitioner will instruct you to correctly to perform a capillary refill before you leave the clinic.


What is expected of me ?

  1. Prior to treatment you have already consented to emergency intervention, there is no compromise here, your consent means that you agree to follow guidance & treatment .
  2. You will remain in clinic until the Practtioner has agreed that it is safe to leave.
  3. You will read all the aftercare & guidance & follow the advice.
  4. You agree to engage with the Practitioner answering calls /or texts promptly.
  5. You will send photographs/video of the treatment area when requested.
  6. You will attend follow-up appointments as requested, please note this may not be at your local clinic, and you should be prepared to travel.
  7. Aspirin will be administered orally and you may be requested to take this for a couple of days.
  8. Heat pad & topical medicine to dilate the blood vessels will also be applied as directed.
  9. Dermal Filler following emergency treatment with Hylase is not indicated for up to three months.


Are there any side-effects from Hyaluronidase ?

Yes as with all medicines there are risks & complications, general risks associated with Hyaluronidase can be a reduction in natural Hyaluronic acid leading to uneven appearance. The injection can be painful, swelling, redness, rash and bruising.

In rare circumstances you may be allergic to this medicine leading to a rare complication called anaphylaxis, which can be life threatening.  Your Practitioner is trained in emergency life support and carries emergency medicines, your safety is always our priority.

It is important to understand that Hyalase will only be effective for treatment with Hyaluronic Acid (HA)Fillers, the volume of HA in Harmonyca is 70% this would reduce the effects of the VO but cannot completely remove 100% of the filler.

North West

East Midlands


Complete the form and we will contact you !

DD slash MM slash YYYY