What Are the Symptoms or Artery Blockage/Damage from Restylane?

In my last post, I suggested that you be aware that blood vessel blockage is also a possibility with ongoing facial pain or numbness after filler treatment. The most significant signs of this would be a color change over the area affected by the artery, such as "duskiness" (purplish or blueish bruise-looking area) or paleness. This would mean there is lack of normal blood flow to the area affected. Sometimes intermittent pain/numbness could be a factor if an artery is spasming (clenching) and then releasing.

However, it does sound like nerve damage is a possible factor in your case, as well. Please do not take the word of distant doctors on a website for your answer. Please go directly back to the physician that injected you, past his or her nurse, and right into the exam room to be checked, just to be sure.

The most common symptoms of a vascular blockage are when patches of the skin turn pale/white (arterial blockage) or purple/deep red (venous blockage).  Of the two, the arterial blockage generally has much higher risks.

Fortunately, most of what appear to be blockages of the vessels are actually external compression of the vessel in question and dissipate fairly quickly and, hopefully, without any significant permanent effects.  That is not always the case, however, and some of the most severe complications of filler injections are due precisely to this phenomenon or, at its extreme, direct injections into the vessel.  These events are, fortunately, extremely rare.

More likely is that you have a nerve injury.  That, too, is most commonly due to compression of the nerve (in your case the infraorbital nerve, coming out just below the orbital bones around your eye).  Rarely, it can be due to direct injury of the nerve.  Assuming it's external compression then it, too, should settle down on its own over a period of several weeks to months (possibly).  In the unlikely even that it's a direct nerve injury the recovery may be more prolonged and potentially less complete.

Either way, you should speak with your physician about this and make sure that he/she is aware of what's happening.  In the early stages, and depending on the mechanism and extent of the problem, hyaluronidase may be useful to "dissolve" the hyaluronic acid.

I hope that this helps, and good luck,

Dr. E