It’s only been a few days since Lilly Ghalichi showed us pictures of her botched filler job and now we can finally ask the question ‘what is vascular occlusion?’.
Over the last ten years the use of dermal fillers has risen exponentially. They have been regarded as a relatively safe way to alter your face. It’s known as a ‘less invasive’ cosmetic treatment.
You can change the shape of your face, nose and cheekbones, without the cost. Once more, they recovery time is reduced when compared to traditional plastic surgery.
These benefits have convinced many to use them. The term ‘non-surgical’ has helped their public acceptance and their growth is continually rising.
However, with the number of procedures increasing, the chance for complications also increases.
One such complication is known as vascular occlusion.
What is vascular occlusion?
Vascular occlusion is when blood is no longer able to pass through a blood vessel, usually because of an internal obstruction like a blood clot or filler.
They can happen in any kind of dermal filler. Using filler regularly just increases your chance of experiencing this.
The best trained injectors can help to dissolve the filler quickly and minimise lasting damage. It’s imperative to use an injector who has extensive experience.
This is what it can look like:


It is essential to treat right away. If left untreated, skin necrosis and tissue death can occur. This is due to insufficient blood supply reaching your cells.
To clarify, necrosis is the death of cells in a tissue or organ. This is usually due to injury, disease or lack of blood supply.
Signs and symptoms
There are a few tell tale signs if you are experiencing this blockage of your blood vessels. These can range in time from a few minutes to days after the treatment.
Initially, right after treatment, experiencing pain and discolouration can be an indication of the compression of blood vessels.
As with Lilly Ghalichi, your skin may also have a blue/grey appearance. This is due to a build up of deoxygenated blood in the tissue.
Some symptoms can appear a few days later, although the reason for this is not understood. This can include skin breakdown again, due to lack of oxygen.
Repair can take weeks via secondary intention.
How do you treat vascular occlusion?
The initial treatment for vascular occlusion is largely dependant on your practitioner. As soon as the injector suspects the blood supply has been compromised, they need to stop treatment.
An initial assessment of the area is crucial in deterring the extent of damage. To do so you can apply moderate pressure to the area with your finger. Note down the time it takes for the skin to return to its normal colour.
If this is less than three seconds you can use conservative measures to increase blood flow. These include tapping/massaging the area and applying heat.
In cases were the reset time is greater than three seconds, speak to your practitioner about antibiotics or a referral to another medical professional.
Where hyaluronic acid fillers are used, hyaluronidase can relieve the problem before complications happen. This will dissolve the filler and decrease pressure on the bloody supply.
In all cases your it is important to have an open dialogue with your practitioner. Treatment is time sensitive. The quicker this can be spotted, the better the outcome.
References
Funt, D., & Pavicic, T. (2013). Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clinical, cosmetic and investigational dermatology, 6, 295.
King, M., Walker, L., Convery, C., & Davies, E. (2020). Management of a Vascular Occlusion Associated with Cosmetic Injections. The Journal of clinical and aesthetic dermatology, 13(1), E53–E58.