Vascular occlusion warning signs (2): pallor
After the initial injection, the next sign of a problem with a VO is usually pallor. In the case of a true, complete vascular occlusion, pallor is very stark, particularly in lips. There will be a grey patch on the lip that sometimes has zero capillary refill.
As with any medical procedure, there are risks involved with the use of dermal fillers. Most side effects associated with dermal fillers, such as swelling and bruising occur shortly after injection and many resolve in a few days to weeks. In some cases, side effects may emerge weeks, months, or years later.
The most important sign of occlusion is poor capillary return on the affected area. In comparison, a bruise will have quick capillary return. The bruising is contained in a certain location and takes on a relatively defined shape, as opposed to discoloration, spreading and a mottled appearance.
In this case, necrosis often turns the skin blue or gives it a blue cast. It can also result in pustules and a scaly look along with white plaques.
If you experience any signs of an allergic reaction after a filler injection, such as tenderness, swelling or asymmetrical fullness, seek medical attention immediately. Ask your doctor to test for allergies to the injectable fillers and/or the liquid gel in which they are suspended.
There are two main types of necrotic tissue present in wounds. One is a dry, thick, leathery tissue usually a tan, brown, or black color. The other is often yellow, tan, green, or brown and might be moist, loose, and stringy in appearance. Necrotic tissue will eventually become black, hard, and leathery.
If you have a vascular occlusion after a dermal filler, you could experience symptoms 12 to 24 hours after your filler procedure. Vascular occlusion is a serious condition that needs medical treatment immediately.
“Capillary refill time is a simple bedside measure to check peripheral tissue perfusion. You apply enough pressure to blanch the tissue and hold for 5 seconds. On releasing, the tissue should reperfuse within 2 seconds,” she instructs. “Also, a bruise will be present where there's been trauma from the treatment.
Late complications are defined as those appearing after about 2-6 weeks. They comprise late allergic reactions, chronic inflammation and infection, granulomas, filler migration, loss of function, telangiectasia, and hypertrophic scars. A detailed history may disclose a potential allergy.
“Pillow face” occurs when too much filler is injected into areas like the cheeks, nasolabial folds (the lines from your nose to the corners of your mouth), lips, and under-eye area. This repeated overfilling can result in a bloated, round appearance that looks far from natural.
Pain: A sudden, severe pain in the treated area is one of the most common signs of a vascular occlusion. The pain may be accompanied by a burning or tingling sensation.
The P's refer to pain, pallor, pulse, paresthesia, and paralysis. Pain is commonly rated on a 10-point scale and can be disproportionately severe in the case of compartment syndrome. Pallor refers to the appearance of the skin and whether it appears as though blood is appropriately reaching the affected body part.
Bruising can appear immediately after your injections, or 1-2 days later. In either case, bruising usually resolves itself after a few days. In some cases, bruises may last up to one week. Bruises generally begin as dark purple or red, then may turn yellow before disappearing completely.
How do you identify blanching following toxin injections? The skin around the injection site(s) will generally turn much paler than your patient's normal skin tone. Often the skin turns completely white, especially in Caucasian patients.
The immediate signs of an occlusion include intense pain in the area, dusky skin, bruising and skin blanching. Bruising is cause by blood leaking into the skin, dusky skin caused by an occlusion will not blanch.
There are several ways to detect occlusions in medical disposable sets including the use of noninvasive pressure sensors, ultrasonic occlusion sensors, flowmeters, or, most commonly, load cell-based occlusion sensors.
Results: Fillers are recognizable on ultrasound and generate different patterns of echogenicity and posterior acoustic artefacts. Cosmetic fillers were identified in 118 dermatological patients; most commonly hyaluronic acid among degradable agents and silicone oil among non-degradable.
Rapid Swelling of the Lips: Significant swelling can develop within minutes on the side where the injection was made. This is due to the filler material expanding within the blood vessels. Bruising and Discoloration: The affected area may exhibit dark, blotchy bruises and a bluish discoloration of the skin.
In some cases, it might be possible to resolve the occlusion with conservative measures, such as massage, tapping, and/or heat applied to the area. However, if conservative methods fail, hyaluronidase should be administered without delay when a hyaluronic acid dermal filler has been used.
There may be no symptoms of osteonecrosis at first, but as the disease progresses, you may gradually start to feel pain, especially in weight-bearing bones such as the thigh bone (femur). The disease most commonly affects the hip joint, and the pain is usually felt in the groin or, less commonly, in the buttock area.
They generally start with mild symptoms like redness, warmth, swelling, or discharge at the infection site. More serious symptoms can include fever, chills, change in mental status, nausea, skin dimpling, or vomiting.
MRSA may look like a bump on the skin that may be red, swollen, warm to the touch, painful, filled with pus, or draining. The pus or drainage contains the infectious bacteria that can be spread to others.