Vascular Occlusion

What is vascular occlusion?

Vascular occlusion is a blood vessel blockage that prevents blood from moving through pathways in your body. Your blood vessels are either your arteries or your veins. Usually, the blockage in your blood vessel is the result of a blood clot or fatty plaque buildup, but it can also happen if your arteries or veins are narrow, making it difficult for blood to move through.

You might be more at risk of developing facial vascular occlusions if you receive lip fillers or dermal fillers. Fillers are a procedure performed by a dermatologist to improve skin imperfections by injecting a substance underneath your skin.

Vascular occlusions are rare but serious if they do occur.

Is vascular occlusion the same as thrombosis?

Vascular occlusion is a general term to refer to any type of blockage of a blood vessel. Thrombosis only refers to blood vessel blockages caused by blood clots. Both conditions can be life-threatening and can lead to a stroke or heart attack.

What happens to my body when a dermal filler causes vascular occlusion?

Vascular occlusion is a rare side effect of a lip filler or dermal filler. During a filler procedure, your provider will inject a filler substance underneath your skin. Fillers can reduce the appearance of wrinkles and make your skin look more youthful. Some common filler substances include:

• Hyaluronic acid.
• Calcium hydroxylapatite.
• Poly-L-lactic acid.
• Polymethyl methacrylate.

In the rare instance that vascular occlusion happens, the filler that your provider injected underneath your skin presses against the blood vessels in your face or was injected into an artery. This pressure affects the circulation of blood underneath your skin, which can cause pain, swelling and color changes to your skin. You might notice these symptoms 24 hours after your procedure.

Contact your provider if you experience pain or skin color changes at the site of your dermal filler. Reduced blood flow to parts of your body can cause dangerous and irreversible consequences if you don’t receive treatment quickly.

What are the symptoms of vascular occlusion?

Symptoms of vascular occlusion include:

• Pain or discomfort at the site of the blockage.
• Swelling.
• Changes to your skin color; red (erythema) to blueish-purple or white spots (blanching).
• Cool temperature to the affected area of your skin.

If you have a vascular occlusion after a dermal filler, you could experience symptoms 12 to 24 hours after your filler procedure.

Vascular occlusion is a serious condition that needs medical treatment immediately. If left untreated, vascular occlusion can cause complications that include:

• Cell and tissue death (tissue necrosis) from a lack of oxygen and blood supply.
• Organ damage or failure.
• Heart attack.
• Stroke.

What causes vascular occlusion?

A blockage of an artery or vein causes vascular occlusion. The blockage could occur as a result of:

• Compression or pressure against an artery by dermal filler substances injected into your skin.
• A blood clot in an artery or vein.
• Fatty plaque buildup in an artery or vein.

Your arteries and veins carry blood from your heart to different parts of your body and back to your heart. A blockage prevents blood and oxygen from moving through your body’s pathways. This causes symptoms of the condition.

How is vascular occlusion diagnosed?

Vascular occlusion is a serious condition and is usually diagnosed in the emergency room. Your provider will take a complete medical history and perform a physical exam to learn more about your symptoms. During your exam, your provider will ask you questions about your symptoms, like:

• When did you first notice your symptoms?
• Did you recently have a procedure for dermal fillers?

Imaging tests, like an X-ray, can confirm a diagnosis and offer your provider a better look at the blockage underneath your skin.

How is vascular occlusion treated?

After an early diagnosis of vascular occlusion caused by dermal fillers, treatment could include:

• Massaging or tapping your skin to release pressure on the blood vessel.
• Applying heat to your skin to improve blood flow.
• Injecting enzymes underneath your skin to break down filler substances (hyaluronidase).
• Taking aspirin to thin your blood and improve blood flow.
• Taking antibiotics to prevent or treat infection if dead cells and tissue (necrosis) are present.

If necrosis sets in on your skin and your provider was able to remove the blood vessel blockage, you might need cosmetic surgery to repair your damaged skin.

How do I manage my symptoms?

If you experience symptoms of vascular occlusion, visit your provider immediately. After treatment to remove the blockage, you might have lingering symptoms of pain and soreness. Your pain might be more intense if you have necrosis. Over-the-counter (OTC) pain medication can alleviate these symptoms. If you don’t experience relief after treatment and your pain is severe, contact your provider.

How can I prevent vascular occlusion?

Vascular occlusion is rare and you can’t prevent all cases of the condition. The best form of prevention is avoiding or limiting the number of dermal fillers you have since vascular occlusion is a side effect of the procedure. If you do receive fillers, choose a trusted provider who specializes in the procedure and uses FDA-approved filler substances.

What can I expect if I have vascular occlusion?

Your prognosis (outlook) for vascular occlusion varies based on when you receive treatment. Early diagnosis and treatment lead to a good prognosis where you’ll be able to make a full recovery with very few side effects. If your diagnosis and treatment are delayed, you could be at risk of permanent skin damage and life-threatening consequences like a heart attack or stroke. Visit your provider immediately if you experience any symptoms of vascular occlusion after a dermal filler procedure.

When should I see my healthcare provider?

Visit your healthcare provider if you experience symptoms of vascular occlusion after a dermal filler procedure, especially pain and color changes to your skin. The condition is serious and needs immediate medical treatment, so don’t delay a visit to your provider if you experience symptoms.

What questions should I ask my doctor?

• Can I get dermal fillers again if one procedure caused vascular occlusion?
• How do I manage my pain?
• Do I need plastic surgery if I have necrosis?

A note from Cleveland Clinic

While dermal fillers are usually a safe procedure, there are possible side effects. Everyone’s body reacts to the fillers differently. Vascular occlusion is a rare but serious condition. If you experience any symptoms after a dermal filler procedure, visit your provider or the emergency room immediately. Don’t wait to receive treatment for vascular occlusion because you could experience irreversible and life-threatening side effects.