Is this bruising necrosis or vascular occlusion 24 hrs after filler? (photos)

It appears you have post injection bruising. It can happen frequently, and will resolve with time. If there are any changes, I would recommend following up with your injector.

This appears to be normal bruising following injection in the nasolabial fold. In general this area is prone to bruising especially if the injections are performed with a needle. Necrosis is usually seen with a blanching of the tissue around the area of concern. You can reach out to your doctor and ask about laser to help reduce the bruising. I also recommend arnica gel and tablets. Good Luck. 

the fact that there is a similar bruise on each side which coincides with the area of insertion of the needle makes me believe this is simple bruising and will resolve in a few days. warm soaks may help .

If this was an occlusion there would be an entire area involved and it would be quite painful. I would be supposed to see an occlusion on both sides.

Hi, 

Thank you for your pictures and question. From your pictures and your description, it looks like this is bruising. Sometimes it is normal to feel discomfort or altered sensation in the lip after nasolabial folds injections due to the proximity of nerve innervating the upper lip in this area. A large bruise may take more than a week to fully resolve. I suggest to follow up with your injector. 

Regards,

After viewing your photos, it appears that you have areas of bruising.   Damaged vessels or occluded vessels would have more extensive bruising, swelling and skin involvement.   I would recommend sending your photos to the surgeon who injected you for best advice.   

Hi there, it looks like you have bruising. It appears not to be damaged or occluded vessels. Bruising gets owrse before it gets better so it's normal for it to look worse. See your provider if you continue to have concerns.