Hyaluronic acid has become a widely used material in cosmetic procedures in recent years, employed for improving skin texture, reducing wrinkles and signs of aging, and localized filling and contouring.However, complications from hyaluronic acid injections are not uncommon, often arising when the substance enters blood vessels, leading to localized necrosis or even blindness. So, what should be done if hyaluronic acid enters a blood vessel?
Ouyang Tianxiang, Director of Plastic Surgery at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, explains that due to its fine texture and low injection resistance, hyaluronic acid can easily enter small vascular networks, potentially causing complications like localized necrosis or blindness.
Unlike fat, hyaluronic acid is soluble. Some cosmetic seekers or unlicensed "micro-cosmetic practitioners" may assume that if hyaluronic acid is accidentally injected into a blood vessel, it's no big deal—just inject hyaluronidase to dissolve it. Is this really the case?
Director Ouyang Tianxiang refutes this notion. While hyaluronic acid is relatively safer than fat injections due to its solubility, this advantage is relative. Once vascular embolism occurs, it becomes irreversible. "Bleeding during injection primarily results from trauma, vascular wall damage, thrombocytopenia and functional disorders, or coagulation factor deficiencies."Generally, three severe complications can arise from filler-related vascular embolism: First, local vascular network compression or embolism causing skin discoloration, swelling, and necrosis. Second, embolism in adjacent vascular networks leading to damage to vital organs or tissues, as well as functional impairments like blindness. Third, distant embolism causing cerebral infarction, pulmonary embolism, and similar conditions."
To prevent complications from hyaluronic acid injections, patients must exercise caution and select licensed medical institutions. Director Ouyang Tianxiang also advises plastic surgeons to be vigilant: "Before treatment, surgeons should ask patients three key questions: whether they have bruises, if their gums bleed easily, and about their menstrual flow."