Vascular embolism: what it is and how it happens

Vascular embolism is the blockage of a blood vessel by material, the embolus, that came from another point in the circulation. In orofacial harmonization, the embolus is the injected product itself: if it enters an artery, the flow can carry it to a smaller vessel and obstruct it. It is one of the best-known mechanisms of vascular occlusion.

How does embolism happen?

Filler deposited inside an artery is pushed along by the flow or by the injection pressure itself. It advances to a smaller caliber and lodges there, interrupting flow to the area that the vessel supplies. In the arteries of the face, which have many connections with one another, the material can also travel against the normal direction of flow, which explains the risk of retinal involvement after injections in the glabella or nose, linked to the angular artery and the circulation of the eye.

Which signs raise suspicion?

• Severe pain, out of proportion to the procedure.
• Sudden blanching of the skin, followed by purplish patches or a lacy pattern.
• Cold skin, loss of capillary refill.
• Visual symptoms: blurring, field loss, double vision or blindness (amaurosis).
• Neurological signs, in rare cases.

What reduces the risk?

No measure eliminates the risk. Safe practice combines anatomical knowledge, conservative volumes, attention to pressure and speed, and the measure of aspiration before injection, without treating it as a guarantee. The consequence of an embolism can be skin ischemia and necrosis.

This warning is part of the informed consent.

In Harmy

The projection shows the possible aesthetic effect of an area, but does not assess vascular anatomy or risk. The highest-risk areas remain a clinical decision.

Also called: embolization.