Experts have warned that cosmetic fillers can lead to blindness and skin loss if injected incorrectly.
The popularity of non-surgical procedures such as fillers has risen by nearly 10,000 by members of the British Association of Aesthetic Plastic Surgeons (BAAPS) in 2024.
Cosmetic fillers are injectable substances commonly used to target wrinkles and smooth or rejuvenate the skin – the most common filler being hyaluronic acid.
But if it is administered incorrectly and the filler is injected into or too close to a blood vessel, it can have major consequences as a result of artery blockage.
Clinics are now advised to perform an ultrasound before injecting dermal fillers to see where the veins are located.
“Vascular occlusion events in the face can be devastating because, if not treated properly, they can cause necrosis and even facial deformity,” said study author Rosa Maria Silveira Sigrist, a radiologist at the Department of Radiology at the University of São Paulo in Brazil.
For the study, which was presented at the annual meeting of the Radiological Society of North America (RSNA), researchers looked at filler-related vascular complications in 100 patients.
In less than half of the cases, ultrasound scans showed no flow to the blood vessels that connect the superficial arteries to the deep face. In more than a third of cases, there was no flow in the major blood vessels.
The areas around the nose are dangerous injection sites, because the blood vessels of the nose communicate with some important parts of the head, including the eyes.
Dr. Siegrist 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 hyaluronic acid fillers. Ultrasound also helps guide doctors to the area that needs treatment.
“If injectors are not guided by ultrasound, they are treating based on clinical findings and injecting blindly,” added Dr. Siegrist.
But if we can see the ultrasound findings, we can target the exact location where the blockage is occurring.
He explained that ultrasound is also a useful tool for guiding filler injections and can help with accuracy, so that fewer are needed and complications are less likely from the outset.
Those who have experienced complications after injecting fillers, emphasized the importance of doing them by a specialist doctor.
Lauren Bateman has said before Independent About how the filler under her eyes made her feel like her “face was exploding” and the infection on her face that could reach her eye. He admitted that the person who prescribed the filler had no conditions.
Ultrasound can help prevent inaccuracies, but BAAPS cautioned that it is still not standard care, although its use is increasing.
Nora Nugent, Chair of BAAPS, said: “Mapping the location of blood vessels will undoubtedly provide valuable information prior to treatment.
Such risks from dermal fillers are one of the many reasons BAAPS has long campaigned to increase regulation of cosmetic procedures and limit the provision of medical procedures such as injectable treatments to those with medical training.
“We hope that the government will eventually make improvements in safety and regulation with the proposed licensing scheme for non-surgical procedures.”
The Government has previously said it plans to introduce restrictions to crack down on ‘cowboy’ beauty procedures which have left people with disabilities, injuries and urgent need for NHS care.
Doctors will be required to meet strict safety, training and insurance standards before they can legally practice. A public consultation will be published in early 2026 ahead of the proposed changes.
