January 29, 2026

Complications from Dermal Filler Treatment – Part 2 – Ischaemia or Vascular Occlusion (VO)

Complications from Dermal Filler Treatment –
Part 2: Ischaemia or Vascular Occlusion (VO)

The word ‘ischaemia’ is taken directly from Latin and Greek and means ‘to hold back blood’.

Ischaemia from dermal fillers arises when the gel or substance is accidentally injected into an artery under pressure. This results in the forcible movement of filler in a retrograde (backwards) direction into more proximal vessels. Occlusion of blood flow can then affect one or multiple vessels, most commonly supplying an area of skin, but also possibly affecting deeper tissues.

How Common is Ischemia?
The incidence of vascular occlusion (VO) varies in published reports varies from 1:6,000 to 1:29,000, so it is very uncommon.
The most feared VO’s are blindness and stroke where filler moves to the retinal artery or brain circulation. There has been some 200+ cases reported worldwide of this. Anecdotally, I have heard of a number of cases coming in to major hospitals in Vietnam from outlying clinics.
Risk factors for Ischaemia –
Some areas are more risky to inject – the frown area, the nose and the nasolabial folds. These areas have significant arteries in close proximity.
The use of larger bore needles and high volume injections increase risk. Cannula use also reduces risk.
Experienced injectors also have reduced rates of VO.
Our Experience –
We have not had any cases of VO at Skin Resus in over 20 years of operation, but we do have strong protocols always in place just in case.
Our nursing and medical staff have between 10 and 20 years’ experience in filler treatments, and new clinical staff undergo approximately 2 years of training in filler techniques.
I have had a filler treatment and I see something I am worried about – We encourage you to call our on-call doctor at any time if you see or feel something that worries you after a treatment – our post-care sheet has this number.