Warning over cosmetic face fillers as scans reveal new details of risks

People who have cosmetic filler injections in their face should be warned of the risk of a dangerous complication involving blocked arteries that can lead to skin loss and even blindness due to damaged blood flow, say experts.

Researchers used ultrasound to study 100 cases of filler injections that had gone wrong.

Clinics are now being advised to carry out ultrasounds before giving dermal fillers in the face, to avoid harming any nearby arteries.

Lead researcher Dr Rosa Sigrist says that, although uncommon, such “vascular occlusion” events – where the filler is injected into or too close to blood vessels – can be devastating because they can cause tissue death and facial deformity if not treated.

Dermal fillers are injectable substances, commonly used to target wrinkles and smooth or “rejuvenate” the skin.

Sometimes they are used to contour or shape the nose or lips.

Areas around the nose are particularly risky injection sites, says Dr Sigrist, because nasal blood vessels communicate with some very important parts of the head.

Damage to these vessels can cause severe complications including skin damage, blindness and stroke, she explains.

Dr Sigrist’s team, from the University of São Paulo in Brazil, studied filler-related vascular complications in 100 patients across four radiology centers (two in Brazil, one in Colombia and one in Chile), one dermatology centre in the Netherlands and one plastic surgery centre in the US between May 2022 and April 2025.

Her work will be presented at a medical conference – the annual meeting of the Radiological Society of North America – this week.

In just under half the cases, ultrasound scans showed absent blood flow to small blood vessels that connect superficial arteries to deep ones in the face.

And in a third of cases, blood flow was absent in major blood vessels.

To avoid complications in the first place, she advises clinics to use ultrasound to plan where to inject.

If complications do arise, ultrasound can guide where to treat.

“If injectors are not guided by ultrasound, they treat based on where the clinical findings are and inject blindly,” Dr. Sigrist says.

“But if we can see the ultrasound finding, we can target the exact place where the occlusion occurs.”

Rather than flooding the area with a drug called hyaluronidase to dissolve the filler, clinicians can do guided injections that use less hyaluronidase and provide better treatment results, she says.

The British Association of Aesthetic Plastic Surgeons (BAAPS) says that the use of ultrasound is increasing, but is not routine or standard care yet.

Ultrasound is non-invasive, does not use ionizing radiation and has no known harmful effects.

Nora Nugent, president of BAAPS, said it was proving very useful in many areas of surgery and medical aesthetic procedures.

“Mapping out the location of blood vessels undoubtedly provides valuable information ahead of treatment.

“Risks like these from dermal fillers are one of the many reasons why we have 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.”

The UK government has said it plans to bring in restrictions for cosmetic procedures.

Under the proposals, only “suitably qualified” healthcare professionals would be able to deliver high-risk procedures such as Brazilian butt lifts.

Clinics administering fillers and Botox would need to meet strict standards to obtain a licence.

A public consultation will be published in early 2026, with views on the range of procedures which should be covered in the new restrictions. Parliament will then decide what to introduce.