Cosmetic filler could lead to blindness and skin loss if it is injected incorrectly, experts have warned.
Non-surgical procedures, such as fillers, are rising in popularity with nearly 10,000 performed by British Association of Aesthetic Plastic Surgeons (BAAPS) members in 2024.
Cosmetic fillers are injectable substances commonly used to target wrinkles and smooth or rejuvenate the skin – the most common filler is hyaluronic acid.
But if it is administered incorrectly and the filler is injected into or too close to blood vessels, it can have major consequences as a result of a blocked artery.
Clinics are now being advised to carry out ultrasounds before injecting dermal fillers to see where the vessels are located.
Study author Rosa Maria Silveira Sigrist, a radiologist at the University of SĂŁo Paulo Department of Radiology in Brazil, said: âVascular occlusion events in the face can be devastating, because, if theyâre not properly treated, they can cause necrosis and even facial deformation.â
For the study, presented at the annual meeting of the Radiological Society of North America (RSNA), researchers studied filler-related vascular complications in 100 patients.
In just under half of cases, ultrasound scans showed absent flow to blood vessels that connect superficial to deep arteries in the face. In over a third of cases, flow was absent in major blood vessels.
Areas around the nose are particularly risky injection sites, because nasal blood vessels communicate with some important parts of the head, including the eyes.
Dr Sigrist warned that damage to these vessels can cause severe complications including skin damage, blindness and stroke.
To treat filler-related complications, an enzyme called hyaluronidase is injected to break down the hyaluronic acid filler material. Ultrasound also helps guide clinicians to the area that needs treating.
âIf injectors are not guided by ultrasound, they treat based on where the clinical findings are and inject blindly,â Dr Sigrist added.
âBut if we can see the ultrasound finding, we can target the exact place where the occlusion occurs. Rather than flooding the area with hyaluronidase, we can do guided injections that use less hyaluronidase and provide better treatment results.â
Ultrasound is also a useful tool for guiding the filler injections themselves and can help with precision, so that less is needed and complications are less likely from the start, she explained.
Those who have experienced complications following filler injections stressed the importance of getting them done by a qualified practitioner.
Lauren Bateman previously told The Independent about how her under-eye filler left her feeling like her âface was going to explodeâ and with an infection on her face that could have reached her eye. She admitted the person who administered the filler didnât have any qualifications.
Ultrasound can help prevent inaccuracies, but BAAPS warned it is not yet standard care, although its use is increasing.
President of BAAPS, Nora Nugent, said: âMapping out the location of blood vessels undoubtedly provides valuable information ahead of treatment.
âRisks like these from dermal fillers are one of the many reasons why the BAAPS has been campaigning for a long time for increased regulation of aesthetic procedures and restricting the provision of medical procedures like injectable treatments to those who have medical training.
âWe hope that the government will finally bring about improvements in safety and regulation with the proposed licensing scheme for non-surgical procedures.â
The government previously said it plans to bring in restrictions to crack down on âcowboyâ cosmetic procedures that have left people maimed, injured and in need of urgent NHS care.
Practitioners will be required to meet rigorous safety, training, and insurance standards before they can legally operate. A public consultation will be published in early 2026 ahead of the proposed changes.
