ISSN 2979-8116 (Online) · Online-only · Published Monthly

    Aesthetic Intelligence

    A peer-reviewed journal of aesthetic medicine, published by the Harley Street Institute

    Social preview card for Vascular Complications in Aesthetic Medicine: Prevention, Recognition and Management

    Review Article

    Vascular Complications in Aesthetic Medicine: Prevention, Recognition and Management

    Dr. Ahmed Haq1

    1. 1 Harley Street Institute, London, United Kingdom

    Corresponding author: journal@harleystreetinstitute.com

    Journal: Aesthet Intell

    DOI: to be assigned

    Volume / Issue: 1 / 4

    Pages: 52–66

    Received: 2025-09-04

    Accepted: 2025-10-22

    Published: 2026-05-21

    Licence: CC BY 4.0

    Abstract

    Background.
    Vascular occlusion is the most clinically significant complication of dermal filler injection. Early recognition and immediate management determine outcome.
    Methods.
    We synthesise published guidelines and consensus statements (2014–2025) and present a structured framework for prevention, recognition and treatment.
    Results.
    A three-stage framework — prevent, recognise, treat — supports immediate clinical decision-making. Hyaluronidase remains the cornerstone of management for hyaluronic acid filler occlusion.
    Conclusion.
    Every aesthetic clinician should hold a written, rehearsed vascular emergency protocol.

    Keywords: vascular occlusion, hyaluronidase, complications, dermal fillers, emergency protocol, patient safety

    1. Introduction

    Vascular complications, though rare, can result in skin necrosis or visual loss. This review provides a structured prevention-and-management framework.

    2. Prevention

    Anatomical knowledge, cannula technique in high-risk zones, low injection pressure and small aliquots reduce risk.

    3. Recognition

    Disproportionate pain, blanching, livedo, delayed capillary refill and vision change are red-flag signs requiring immediate response.

    4. Management

    High-dose hyaluronidase administered locally, warm compresses, aspirin and urgent ophthalmological referral where vision is affected, are first-line interventions.

    5. Conclusion

    A pre-rehearsed emergency response is the most important determinant of outcome in vascular complications.

    Competing Interests

    The author(s) declare no competing financial or non-financial interests relevant to this work.

    Funding

    This work received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

    Ethics & Consent

    Where applicable, ethical approval and informed patient consent were obtained in accordance with the Declaration of Helsinki. Reviews and commentaries did not require ethical approval.

    References

    1. DeLorenzi C. New high dose pulsed hyaluronidase protocol for hyaluronic acid filler vascular adverse events. Aesthet Surg J. 2017;37(7):814–825.
    2. Beleznay K, Carruthers JD, Humphrey S, et al. Update on Avoiding and Treating Blindness From Fillers. Aesthet Surg J. 2019;39(6):662–674.
    3. Kapoor KM, Kapoor P, Heydenrych I, et al. Vision Loss Associated with Hyaluronic Acid Fillers. Aesthet Plast Surg. 2020;44(3):929–944.
    4. Urdiales-Gálvez F, Delgado NE, Figueiredo V, et al. Treatment of Soft Tissue Filler Complications: Expert Consensus Recommendations. Aesthetic Plast Surg. 2018;42(2):498–510.

    © 2026 Harley Street Institute. Published under the Creative Commons Attribution 4.0 International Licence (CC BY 4.0).

    ← Back to Current Issue

    Editorial Masthead

    Aesthetic Intelligence

    A peer-reviewed journal of aesthetic medicine, published by the Harley Street Institute

    Publisher
    Harley Street Institute
    8-10 Harley Street, London W1G 9QD, United Kingdom
    Format & Frequency
    Online-only · Published Monthly
    Established 2026
    Editor-in-Chief
    Dr Hena Haq
    Peer Review
    Single-blind external peer review by at least two reviewers for original research and review articles; editorial review for commentary and editorial content.
    Editorial Office
    Editorial Office, Aesthetic Intelligence, Harley Street Institute, 8-10 Harley Street, London W1G 9QD, United Kingdom
    journal@harleystreetinstitute.com
    License
    Articles are published under a Creative Commons Attribution 4.0 International License (CC BY 4.0) unless otherwise stated. Authors retain copyright.
    ISSN (Online)
    ISSN 2979-8116 (Online)The International Standard Serial Number (ISSN) is the official identifier assigned by the ISSN UK Centre at the British Library. It confirms Aesthetic Intelligence is a catalogued, citable serial publication of record, indexed in the global ISSN Register and recognised by libraries, abstracting services and indexers worldwide.
    Indexing
    Applications planned with DOAJ, Crossref, PubMed Central and Scopus during Volume 1 (2026). The journal follows a monthly publication model (one issue per calendar month) with sequential issue numbering within each volume.