Bold warning: cosmetic facial fillers can trigger dangerous blockages in arteries that may cause skin loss or even blindness. That alarming risk is the focus of new research based on ultrasound scans from 100 filler-related incidents. The findings urge clinics to use ultrasound planning when performing dermal fillers to avoid injuring nearby vessels.
Lead researcher Dr. Rosa Sigrist notes that vascular occlusion — where filler enters or sits too close to blood vessels — is rare but potentially devastating if not treated promptly. It can lead to tissue death and noticeable facial deformities.
Dermal fillers are injectable substances used to smooth wrinkles, restore volume, and rejuvenate the face. They’re also employed to contour features like the nose or lips. The nose region is particularly high-risk because nasal vessels connect to critical brain and facial structures, making any damage potentially severe, including skin injury, blindness, or stroke.
The study, conducted by Dr. Sigrist’s team at the University of São Paulo, examined 100 patients across facilities in Brazil, Colombia, Chile, the Netherlands, and the United States between May 2022 and April 2025. The researchers plan to present their work at the Radiological Society of North America (RSNA) annual meeting this week.
Ultrasound revealed that in nearly half of cases, small facial vessels lost blood flow due to occlusion, while about a third showed reduced flow in larger vessels. These patterns underscore the importance of precise injection sites and real-time vascular assessment.
To prevent complications, Dr. Sigrist recommends ultrasound-guided planning before injections. If a complication occurs, ultrasound can help pinpoint the exact occlusion site to direct treatment. Instead of immediately flooding the area with hyaluronidase, a dissolving agent, targeted injections guided by ultrasound can reduce the amount of hyaluronidase needed and yield better outcomes.
Professional voices are increasingly supporting ultrasound use, but it is not yet standard care. The British Association of Aesthetic Plastic Surgeons (BAAPS) notes growing adoption but also emphasizes that ultrasound mapping should be routine to improve safety. The technique is non-invasive, avoids ionizing radiation, and has no known adverse effects.
BAAPS President Nora Nugent highlighted ultrasound’s value in planning and executing procedures, while cautioning that filler-related risks fuel ongoing calls for tighter regulation of aesthetic treatments and for restricting injectable procedures to adequately trained medical professionals.
Policy developments are in motion in the United Kingdom. The government has proposed restricting cosmetic procedures and licensing requirements to ensure only suitably qualified healthcare professionals perform high-risk treatments like Brazilian butt lifts. Public consultation on which procedures should be covered is slated for early 2026, with Parliament set to decide the final framework.
