Dermal Fillers: Understanding Potential Complications


A growing number of doctors have been exploring the use of dermal fillers in their practice as a way to grow revenue.  While this expansion of services seems to flow naturally from the knowledge and experience you already have, there are some complications that can arise… Knowing what to do when (and how to avoid it altogether) is imperative.


Severe complications from simple filler procedures are rare. Still, having an action plan prepared and on hand during every filler treatment is important.  It’s possible that at some point a patient will develop a vascular occlusion – which  is a blockage of a blood vessel, usually with a clot.  This is where your action plan becomes imperative.

“Have a protocol in your office so that if (vascular occlusion) happens, you can start moving down the line of interventionist processes”  recommends Dr. Chestnut. This is great advice. In a worst case scenario, vascular occlusion can lead to stroke like symptoms or even blindness. Knowing what to do and how to make sure that the patient recovers well is critical.


To avoid the chances of blockage in a carotid artery, Dr Chestnut advises simply that you be aware that carotid vessels are not in the exact same place for everyone. So, caution should be used when injecting. Dr Chestnut recommends you “inject slow, small increments of filler with minimal pressure. Keep the needle tip moving so that if you cannulate a vessel, you’ll get in and out of it quickly.  Use caution in surgical areas. Know your patients history and if they’ve had surgeries in the injection areas that might compromise the procedure.”

To ensure preparedness for any situation, you should have what Dr. Chestnut calls a “filler first aid kit.” Make your staff knows where the kit’s at and how to use it should there be an emergency

“Be looking for vision or neurological symptoms, and if you spot them you need to do a warm massage and compress, have them chew on an aspirin, and have on hand topical nitrogen paste and hyaluronidase injection to dissolve the filler.  Know who your local ophthalmologist or ocular surgeon is, and have those numbers in your first aid kit.  If you see neurological symptoms, call the ER and let them know what’s happening so they an get the stroke team and neurologist ready for your patient”


As many practices continue to explore the arena of fillers as a way to augment their business, proper training and understanding of filler treatments are essential for professional and safe procedures.  If you’re new to fillers but considering it for your practice, consider The A+MD Symposia as a must-have experience for you and your entire team!

DesireJonathan McClung