Filling with hyaluronic acid requires attention to signs of vascular occlusion

The biggest demand for hyaluronic acid filler is the treatment of Chinese mustache, dark circles and lips. Photo: Bigstock

Hyaluronic acid is present in our body with the main functions of hydration and maintenance of tissues such as skin and joints. Filling the body with this acid is also one of the most widely performed cosmetic procedures in the world, along with chemical peels and botulinum toxin.

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To be eligible for this type of intervention, with greater safety and efficiency, the ideal is to carry out a detailed medical interview and a thorough clinical examination, in which the doctor will plan which gel will be applied, what will be the quantity and which regions need to be treated to achieve the desired effect.

However, even with all precautions, unwanted effects can occur. Among them, vascular occlusion is the most serious, according to information from dermatologists Paula Schiavon, president of the Paraná regional office of the Brazilian Society of Dermatology and Francine Belinetti, professor of medicine at the Pontifical Catholic University of Paraná (PUCPR) :

Filling with hyaluronic acid

The procedure consists of applying a gel with the substance on the key points of the face, with a beautifying and rejuvenating function. “Depending on the indication, the gel can be applied near the bones, in the deep fat compartment, near the skin or even between the muscles of the face,” explains Paula.


The biggest application of hyaluronic acid filler is to treat Chinese mustache, dark circles and lips. “Other good indications include improving the support and contour of the face, repositioning the eyebrows, treating the chin and jaw and even correcting certain types of noses,” says Paula.

According to Francine, hyaluronic acid is successful in reducing expression lines, replenishing volume lost with the aging process, improving facial contour, correcting scars and even smoothing asymmetries. “This procedure is known as face filling and, depending on the characteristic of the hyaluronic acid used, it can involve different effects, from mild hydration to effective volumization,” she explains.

Mild and severe reactions

As with any procedure, explains Francine, the filling is not without risks: it can progress with swelling, bruising and local pain, which are generally transient.

After the procedure, it is expected that bruising will appear and the treated areas will be painful and slightly swollen. “Finally, a few weeks after application, if the volume injected is higher than necessary, or if the injection is at the wrong depth, the face may be rounded and with nodules”, quotes Paula, specifying that the allergic reactions rarely occur.

Among the more serious and permanent effects that can also occur, according to Francine, are infections and occlusion of vessels. “In extreme cases, the patient can develop areas of necrosis and even blindness,” she says.

Signs that something is wrong

The most serious complication is vascular occlusion after filling. “The signs are: intense and progressive pain a few hours after application, a change in the color of the skin where the application was made, from paleness to redness, the appearance of purplish spots or small blisters. These signs represent an emergency and the doctor should be contacted immediately, ”explains Paula.

Whitening of certain areas of the face and the gradual increase in bruising (purple), severe swelling, visual changes and changes in skin sensitivity are also important signs that require examination.

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