Over 5 million annually Cosmetic filler procedures However, these injections can block important blood vessels, putting patients at risk of serious harm.
In a study presented this week at the Radiological Society of North America (RSNA) annual meeting in Chicago, doctors found that ultrasound technology can help detect these dangerous blockages early, guide treatment, and prevent lasting damage.
Researchers looked at data from 100 patients at six different locations. Vascular complications After hyaluronic acid filler injection. All data was collected between May 2022 and April 2025, according to a press release.
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They found that ultrasound was successfully detected Vascular occlusionthis is a blockage in the blood vessels and normal blood flow stops.
Untreated, this condition can cause pain, skin damage, scarring, and in more severe cases, vision loss and stroke.
“Doppler ultrasound helps doctors accurately see the filler’s location, blood flow in real time, and whether blood vessels are affected after injection. cosmetic surgery,” lead researcher Rosa Maria Silveira Sigristo, MD, a radiologist at the University of São Paulo in Brazil, told FOX News Digital.
“While the physical exam remains very important, ultrasound adds additional information, making evaluation safer and treatment more accurate.”
The study found that more than 40% of patients had blockages in small connecting blood vessels, perforators, and 35% had major facial arteries with no blood flow.
of nose part The lateral nasal artery was identified as the area most at risk because it runs along the side of the nose and supplies blood to the larger arteries that go to the eyes and brain.
“Vessel occlusion after filler injection can have devastating consequences, including skin necrosis, tissue loss, and, in the worst cases, blindness or loss of vision. even stroke” Dr. Anthony Barrett, a board-certified plastic surgeon in New Jersey who was not involved in the study, told FOX News Digital.
“When vital arteries, such as those that feed the retina and skin, become occluded by fillers or emboli, the damage can be irreversible.”
According to Dr. Samuel Golpanian, a dual board-certified plastic surgeon in Beverly Hills, the risk of vascular occlusion should be less than 1 percent when used by an experienced, qualified professional and using proper techniques.
“But if the filler is performed by an untrained person or the wrong needle or method is used, the complication rate can be even higher, between 10% and 20%, which is completely unacceptable,” Golpanian, who was also not involved in the study, told FOX News Digital.
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Ultrasound helped doctors pinpoint the location of the blockage, allowing them to properly place the lytic enzyme (hyaluronidase) where it was needed, avoiding guesswork and large doses.
The researchers suggested that using ultrasound during the injection itself could prevent blood vessel damage and allow for faster and more precise treatment if a blockage occurs.
“Ideally, Need to integrate ultrasound We incorporate it into care in a way that supports timely decision-making, either as an immediate point-of-care tool in trained hands or to confirm and optimize management once initial rescue therapy has been initiated,” Asif Pilani, MD, a board-certified cosmetic plastic surgeon in Toronto, Canada, told FOX News Digital.
To minimize dangerous complications, Pirano, another outside expert not involved in the study, emphasized that injectable treatments should be performed by board-certified experts with formal training in facial anatomy and complication protocols.
The study has several limitations, including the relatively small sample size (100 adults) and the fact that the study is still young. peer reviewed.
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“Another limitation we noticed is that Doppler testing is performed differently among so many people. experienced professionals” the lead researcher told Fox News Digital. “This shows how important it is to create clear, standardized guidelines so that trials can be conducted in a more consistent manner.”
Additionally, all study participants experienced severe complications, so the findings may not apply to milder cases or people with different types of fillers.
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Additionally, the study was conducted in Brazil, so there may be some geographic bias. Training standards may be different in Brazil than in the United States.
Future studies are needed to follow more patients over time and track their recovery after ultrasound-guided treatment, the study notes.
