Does a vascular occlusion from filler happen because of bad technique?

Question

I recently had Juvéderm injected into my lips. I’ve had this done about 4-5 times and I’ve never had any problems. This time, however, I had a vascular occlusion above my lip. Luckily, it was caught early and didn’t cause any major damage. I was wondering if this happens with inexperience or bad technique, or if this is something that can happen to even the most experienced injector. Thanks!

Monica Boen, MD · Answer

Vascular occlusion is a risk with dermal filler injections and can happen to experienced injectors as well as novices. However, you can significantly reduce your risk for this and other side effects by selecting a board-certified physician with extensive experience in dermal filler treatments. If your injector had these qualifications, chalk it up to bad luck and know the risk of it occurring again is relatively small.

Jason Emer, MD · Answer

this can happen to anyone experienced or not. cannulas help limit the issue but aren't full protection. this is typically frank bad luck.  Best, Dr. Emer.

Harold J. Kaplan, MD · Answer

Hello Cathy. The answer to your question is yes it can.  Injecting retrograde (pulling out the needle while applying pressure), aspirating before injecting and injecting more superficial or deeper than major blood vessels can help to decrease the chances of an occlusion, but they canhappen to even the best injectors.

Camille Cash, MD · Answer

Developing a vascular occlusion is a risk with lip fillers and can happen with any injector.  Using an experienced injector is still important for several reasons.  Identifying any occlusion early and treating it appropriately is certainly one of them.

YOU aesthetics - Corona Del Mar · Answer

Vascular occlusions can happen to even the most experienced injectors!  
Experienced injectors should know the anatomy, where vessels are located, when to go superficial vs. deep, etc., but even with this knowledge, it can still happen.  Not everyone's anatomy is exactly the same.  The most important thing is that you are going to a properly trained and qualified injector who knows how to properly handle and treat and event like this, should it occur.

Center for Aesthetics and Plastic Surgery - Grand Rapids · Answer

Hello there! I am so sorry that this happened to you. There are definitely steps that can be taken to decrease your risk of an occlusion, but even the most experienced injector can cause an occlusion. This is unfortunately one of the risks of injectable fillers. Sarah RN BSN

Evelyn Feng, MD · Answer

Vascular occlusion can happen in the most experienced physicians.  But it minimizes the risk when you go to someone with experience and knows the surface anatomy and knows the depth of injections. It can also decrease somewhat by using cannulas

Leonard Grossman, MD · Answer

Vascular occlusions can occur even in the hands of the most experienced of doctors. vascular occlusions are less common when a small cannula is being used instead of a needle, but it's can still occur when a blood vessel is penetrated by the needle and a small amount of filler is being injected into the blood vessel. Good luck from New York City

Denis L. Gonyon, Jr., MD (account suspended) · Answer

Occlusions can happen even to experienced injectors.  In our office, we keep an Occlusion Kit available at all times in case this situation occurs.  Hylenex is a filler dissolving agent that can be administered in the event that an occlusion occurs.  I encourage you to ask your injector if Hylenex is available at the facility and is there a protocol for when and how to administer Hylenex.  This is an important safety measure to ensure that you are receiving the safest care.

Does a vascular occlusion from filler happen because of bad technique?

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