I got a Juvederm injection last week. She gave me vascular occlusion and beginning stages of necrosis. How to stop it? (Photo)

Question

Juverderm plus injected directly into my artery. On week 2 now looks more like second degree burn after melting some filler out. What/ how can I fix this and will I need corrective measures.

Stephen Prendiville, MD · Answer

This is a rare but serious complication with fillers.  It looks as if the inferior labial artery was affected based on the photos.  This should be a fairly deep artery that should be out of the plane of injection  when treating the lip.  My first point is tat you need to be under the guidance of an experienced facial plastic surgeon, plastic surgeon, or dermatologist.  Although such complications could happen to any Injector, it would be far more preferable to see a Core Trained Physician with knowledge of facial anatomy and blood supply for future fillers.  This complication may lead to objectionable scarring; only time will tell.

John J. Martin, Jr., MD · Answer

This is an unfortunate complication of filler.  It sounds as though they used hyaluronidase to "melt" it out.  That is the most important thing to do when this occurs.  With a vascular occlusion the skin usually turns white and it can be painful.  This is when the treatment to dissolve needs to start. It is recommended that high doses of enzyme are injected every hour until it appears as though blood flow has returned.  All of the other modalities such as nitropaste, aspirin etc. are not nearly as important as high dose hyaluronidase.  At 2 weeks there is no benefit to adding more enzyme.  You should keep it moist with some topical antibiotic cream.  Warm compresses will also help.  As it heals, you may benefit from some laser treatments to improve the texture of the skin if necessary.

Thomas Fiala, MD, FACS, FRCSC · Answer

I am sorry to hear of your situation.  I'd recommend:Lots and lots of hyaluronidase.  Repeat.Nitropaste, aspirin, medrol dosepack.Topical wound care.Even consider hyperbaric oxygen treatments.

Jonathan Kulbersh, MD · Answer

I recommend following up with your injector or a Doctor as soon as possible. The filler can be reversed with hyaluronidase and should be treated with topical vasodilators (nitropaste) as prevention. I hope this helps.

Monika Soni, MD · Answer

Thank you for your question. It is difficult to give you advice without examining you in person. However, if necessary you can have the filler dissolved with hyaluronidase. I recommend having a follow up with your injector for an evaluation. Best of Luck!

I got a Juvederm injection last week. She gave me vascular occlusion and beginning stages of necrosis. How to stop it? (Photo)

Answers (9)

Answer: Vascular Occlusion after Lip Injections

Answer: Vascular Occlusion after Lip Injections

Answer: It is difficult to give you advice without examining you in person.

Answer: It is difficult to give you advice without examining you in person.

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Everything you need to know about Juvederm

Our mission is to create a world where every investment in modern beauty is Worth It.

I got a Juvederm injection last week. She gave me vascular occlusion and beginning stages of necrosis. How to stop it? (Photo)

Answers (9)

Answer: Vascular Occlusion after Lip Injections

Answer: Vascular Occlusion after Lip Injections

Answer: It is difficult to give you advice without examining you in person.

Answer: It is difficult to give you advice without examining you in person.

Browse related questions

Recommended reading

Everything you need to know about Juvederm

Our mission is to create a world where every investment in modern beauty is Worth It.