Want lip filler, but I'm petrified of the risks of vascular occlusion - advice?

Last year there were something like 8 million filler treatments. Vision loss is rare and a reasonable estimate is there are about 20 of these cases a year. The puts the risk of vision loss at about one in about 250000 treatments. That is a number that is so low, it is hard to think about the risk. Certain factors increase the potential risk. First half of these cases seem to take place in South Korea. Injecting small volumes makes a difference. The use of a cannula may or may not make any difference. The lip is an area seldom associated with vision loss. If you can't accept these low levels of risk, it is understandable. Don't have service. However, many understand the risk is quite low and are comfortable having service.

Thanks for your question.
I understand you are worried about the possible risk of vascular occlusion with fillers.
For this reason these procedures are medical procedures and should only be performed by highly skilled and fully trained medical professionals (e.g. doctors/surgeon) with deep knowledge and expertise in facial anatomy (including facial arterial and venous structure) who are able to identify the "danger zones" and reduce the potential complications.
I would recommend to make a consultation with an experienced aesthetic doctor for a detailed assessment and consider the best suitable treatment and risks/benefits involved.
Hope this helps, Best Wishes, Dr Giuseppe Fiore

VO risk in lips can be minimised if your medical professional uses a cannula instead of a needle.Cannula has a blunt tip and is much safer.Also VO in lips does not lead to blindness and can be reversed immediately with hyaluronidase

Hi there! The most common side effects of dermal filler are redness at the injection site, bruising, and lumps. Vascular occlusion, which is when filler is unintentionally injected into a blood vessel, can lead to serious complications like tissue death or blindness if the filler isn't quickly dissolved. This is an extremely rare occurrence and the risk can be reduced by seeing an experienced provider who is well versed in facial anatomy and who knows how to manage emergency situations. Hope this helps!

You are right it is a concern having a VO. It is rare and you can minimize risk by using an experienced clinician who can recognize and deal with a VO. Canulla can be used and may reduce risks

Hi,Vascular occlusion is a real but extremely low risk with HA filler. In the last study I read on this (see below), the risk of a vascular occlusion was found to be 1/6000 when needle are used, and much less likely when cannulas are used. 85% of those occlusions that did occur were minor, with zero long term issues.
It is best to speak with an experienced specialist who understands the tools, the products, who can analyze your anatomy and listen to your desires. All these will help minimize the risk of untoward outcomes.
Source:Alam M, Kakar R, Dover JS, et al. Rates of Vascular Occlusion Associated With Using Needles vs Cannulas for Filler Injection. JAMA Dermatol. 2021;157(2):174–180. doi:10.1001/jamadermatol.2020.5102

There is risk with any treatment that you may consider, but it is important to weigh the risk with the benefit. There is no way to completely remove the risk of vascular occlusion but you can take comfort that it is rare. Selecting an experienced injector will also work in your favor. The benefit is that you can improve the appearance of your lips, and thus your confidence.

In life, every second that we are awake, involves some kind of a risk being taken. You could easily slip on the floor in your own bathroom and hit your head on the toilet, and never wake up. Take a plunge and get your lips filled if this is what you have wanted. Make sure you go to a plastic surgeon who preferably uses Cannulas if you are so scared instead of needles. I hope this helps and good luck from New York City Plastic Surgery.

Do you drive a car?
Do you ride in cars?
Do you know what the mortality is used automobiles?
The mortality of an average driver is one out of 10,000 per year.
That means driving a car as an average driver for 30 years puts you at a 1 in 333 chance of dying from a car accident.
What’s the percentage of people who become blind especially blind on both sides from the use of lip fillers?
I’ve never heard of a case but I know they have been reported.
Risk stratification needs to take both risk rate and severity of outcome into account.
A lot more people have been struck by lightning and have been blinded by getting aesthetic filler treatments.
If you make decisions based on emotions then your life is being driven by emotional decision making.
Nobody has to have aesthetic procedures.
There are risks involved with everything in life.
Life after all is a fatal condition.
One way to reduce the risk of vascular injury when doing lip work is to inject the lips with lidocaine with substantial amounts of epinephrine.
Most providers use topical local anesthetic to keep their patients comfortable. I do that as well but before injecting the fillers I typically inject very small amounts of 2% lidocaine mixed with a ratio of 1 to 33,000 of epinephrine.
That concentration is safe when used in small amounts and causes temporary severe constriction of the labial artery and vein. The chance of vascular injury with the vessels completely constricted basically completely shutting off the blood supply to the lip is minimum.
I don’t do this to prevent intravascular injections of filler because that is an extremely rare occurrence. I do this to minimize patient’s bleeding and bruising after the procedure.
I also never inject or placed a needle anywhere close to the labia artery. By knowing where the maybe your vessels run and properly vasoconstricting the tissues before injecting a chance of a vascular injury goes down to close to zero.
The patient feels no pain during the injection and allowing me to take my time and fine-tune my injection technique to get high-quality results.
If I need to do touchups then re-injecting reinserting the needle in the lip causes no pain and virtually no bleeding.
I’m not sure why this technique has not been adopted by more providers but it seems to work extremely well in my hands.
The use of epinephrine in lips before injecting fillers makes the process much easier for both patient and provider.
In my opinion what patients should be concerned about his choosing a provider who really doesn’t know how to do the procedure well.
There’s a lot of bad aesthetic work being done and I see it on a daily basis.
Quality aesthetic work should never look like someone is had a treatment.
If you look at the worst case scenario for every decision you make you may never end up leaving the house.
It’s a free world and no one has to have lip fillers.
Best,
Mats Hagstrom MD

Hi and welcome to our forum!Let's see...The risk of vascular occlusion following lip filler injection is less than 0.05%. It is usually rapidly recognized / treated and resolves without sequelae. The risk of actual tissue necrosis occurring as the result of vascular occlusion is reported as 1/100,000. For comparison, the lifetime risk of death from a motor vehicle accident is 1/107! I hope it sounds less scary...Best wishes...