Vascular occlusion 1 day post Juvederm in lips. Am I still occluded? Permanent damage? No hyaluronidaise was used. (photos)

I would always recommend dissolving the filler with Hyaluronidase in cases of suspected or proven vascular occlusion. Consequences can be devastating if it is not treated appropriately. Make sure your doctor is experienced in dealing with filler complications. Best wishes.

A suspected vascular occlusion should always be evaluated in person and all necessary steps must be taken to prevent necrosis of the skin. This is not a problem that should be managed over the phone.  Best of luck. 

I recommend seeing your injector or Doctor today. If necessary, the filler can be reversed with hyaluronidase. Hope this helps.

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!

Wow! Any suggestion of vascular occlusion should have the injector all over this case. Hyaluronidase as mentioned by all of the other doctors answering this question is absolutely mandatory. Take no chances. If the hyaluronidase was not really necessary then that’s not a bad thing but if it is necessary and it is not given then that is a tragedy.  Hyaluronidase should hopefully reverse the occlusion and allow the blood to bring oxygen to the tissues. I’m not even sure why the prednisone would’ve been used. The treatment would’ve been early use of Hyaluronidase. You look like you may end up being OK but it looks like a close call. 

even though the face is well vascularized, a vascular occlusion anywhere should not be taken lightly. There are certain protocols which have been established for the treatment after vascular oclusion is diagnosed. You should be seen by your doctor probably daily in order to establish the best mode of treatment. At this point in time since you have not received any hyaluronidase I would try to get hyperbaric treatment as soon as possible and continue to do so for the next 5 days. Good luck from New York City

Hello, it is surprising your injector did not inject hyaluronidase for risk management of necrosis. I recommend you see an experienced cosmetic physician today who may give you further treatment. Good luck.

This is a hard question to answer, as most physicians and specialist will do everything they can ASAP to reduce skin necrosis. This includes GTN, Aspirin, Nifedipine, and most importantly Hylase to break down the HA within the vessel wall. This is Gold Standard treatment if vascular occlusion occurs. Some even take the necessary steps for hyperbaric oxygen. Vascular occlusion in my option should be managed seriously, and with hylauronidase to the area supplied by the vessel and their end arteries. My suggestion is that you seek a second opinion. Dr Isobel Walker, Brisbane. Australia. 

Hi bootywanted,I'm sorry but you might want to see another doctor. Vacular occlusion usually does not resolve on its own. It would be best to dissolve any remaining blockage with hyaluronidase. All the best,Justin Harper, M.D.