Juvederm in lips: blood vessel blocked. Is it the esthetician "fault"? A regular at clinic. Licensed esthetician.

Question

Esthetician suddenly gets extremely focused and started to massage lip, nurse brought hot cloths, icing. Another esthetician was contacted. My skin had gone pale on left side above lip, but Short after it was gone, she told me and explained. Luckily I just ended up with a bruise on lip one above lip. 4 days post its fading. My concern; is this state something an esthetician can make sure is avoided? Should I consider changing esthetician? Been happy with previous lip procedures by her. Thank you

Matthew Schulman, MD · Answer

In New York State, estheticians (even if "certified") are not permitted to perform Botox or Filler injections. Doing so would be considered practicing medicine without a license. I would strongly advise you to seek the help of a Board Certified Plastic Surgeon or Dermatologist. The treatment for this "vascular emergency" is not ice or massage.....the treatment is immediate injection of Hyaluronidase which is another thing that estheticians are not licensed to administer. You should seek treatment immediately in case things are not as improved as you think. I am also concerned that there is a clinic in my own state that allows estheticians to provide invasive treatments. This is unethical AND illegal and for very good reason. They failed to provide the appropriate immediate treatment at the time of this vascular emergency.

Calvin Jung, MD · Answer

All lip injections are handled by myself as the vascular flow to the face is paramount.  I employ a cannula technique to decrease the chance of bruising as well.
Having said that, all physicians likely have had a bruise in the past and while avoidable even the most seasoned injectors get a bruise now and then.

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!

Hardik Soni, MD · Answer

Thank you for your question. Estheticians in New York State are not permitted to perform Botox or Filler injections. Performing these is considered practicing medicine without a license. Ice and massage is not the treatment for a “vascular emergency”. This needed to be immediately dissolved with hyaluronidase. This is also not allowed to be administered by estheticians. I recommend finding a reputable and licensed injector to have your filler immediately dissolved before the problem becomes worse. Best of Luck!

Stephanie Olivier, MD, FRCSC · Answer

Thanks for excellent question. You should never had a injection done by a esthetician. You should get  your injection done by a doctor. What you had is a vascular occlusion secondary to fillers injection in blood vessel. It is A EXTREMELY SEVERE COMPLICATIONS. Hopefully in your case, it went away, but you can had a really bad skin necrosis ( meaning skin that not survive in area that was white). You should consider to go somewhere else done by a board certified either plastic surgeon or doctor. wish you all the best

Michelle Ellern, DO · Answer

Physicians perform these procedures in order to deal with any complications that may occur. From the description it sounds like you had an incorrectly treated vascular occlusion. If there is even the slightest hint of a vascular occlusion the product needs to be dissolved immediately until area is no longer showing signs of decreased flow. I would follow up with an experienced physician injector asap to have the area examined and discuss options.

Faiyaaz Kalimullah, MD, FAAD · Answer

I'm very sorry to hear that you experienced vascular occlusion after your lip filler injections.  Vascular occlusion is a rare complication of filler injections, that occurs when fillers are injected into a blood vessel, or compressing a blood vessel, cutting off blood supply to the skin.  Although it can occur in even the most experienced hands, it is more likely to occur with less experienced injectors.  This is a serious emergency, that can result in extensive, permanent scarring.  Ice and massage are not appropriate treatment for vascular occlusion - standard of care is immediate injections of a medication called hyaluronidase, to dissolve the filler and restore blood supply.  Some of the consequences of vascular occlusion are not visible until several days after it occurs, and areas that may necrose and scar can look like bruises early on.  I would still recommend seeing an experienced cosmetic dermatologist or plastic surgeon immediately.
Laws vary from state to state, but it's highly unlikely that it is even legal for your aesthetican to be performing filler injections.  I would suggest that you only see a board-certified dermatologist or plastic surgeon for future treatments.

Steven F. Weiner, MD · Answer

It sounds like a case of vascular occlusion. This can happen to all injectors but more likely to occur in the less experienced ones. I'm not sure of the legality of an aesthetician injecting dermal fillers. I would use a physician who is board certified in Plastics, Dermatology, or Facial Plastics in the future. I do all my own injections because there are risks associated with fillers which are downplayed by most injectors.

Chris Thiagarajah, MD · Answer

Did anyone in inject Wydase or Vitrase to dissolve it? This is what happens when patients get procedures with a non-physician. Once there is a disaster, they come on Realself asking for advice. Go to another aesthetician? Wait until the lip heals.  Probably better to get it done with an MD.  Best of luck to you but its seems you haven't learned your lesson.

Allison Readinger, MD · Answer

Vascular injection can and does happen on rare occasion even with good injection technique. It does sound like she did the right thing using massage and heat to bring blood flow back to the area. It's also helpful to have a reversal agent available called hyaluronidase.  This can be used if Juvederm is inadvertently injected into a vessel especially if massage and heat don't work. 
Check laws for esthetician injection in your state. These laws vary from state to state. In any area, I'd make sure there is good physician oversight (if you don't use a physician) in case there is a real problem.

Juvederm in lips: blood vessel blocked. Is it the esthetician "fault"? A regular at clinic. Licensed esthetician.

Answers (14)

More Juvederm Questions

WE SEND PRETTY
EMAILS

Answers (14)

More Juvederm Questions

Hard painful lumps 3 months after fillers.

I had Juvederm lip filler today, it blew straight up on the left side and bruised. Is this bruising a burst vessel? (photo)

Juvederm Ultra in lips-- smile looks bad, so painful

Does this look normal after .6ml of Juvederm in the top lip and .2ml in the bottom? (photos)

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS