Ultrasound Scans Could Prevent Blindness and Tissue Loss from Cosmetic Fillers
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A new study highlights the critical need for enhanced safety protocols in cosmetic filler injections,with experts urging clinics to utilize ultrasound technology to mitigate the risk of blocked arteries,skin loss,and even blindness. Researchers have found that vascular occlusion – the blockage of blood vessels by filler – while uncommon, can have devastating consequences if left untreated.
Dermal fillers, popular injectable substances used to reduce wrinkles and rejuvenate skin, carry inherent risks. The procedures are also frequently used for facial contouring, including the nose and lips. However, injections around the nose pose a particularly high risk due to the complex network of blood vessels connected to vital areas of the head. Damage to these vessels can lead to severe complications, including skin necrosis, vision loss, and stroke.
A recent study, led by Dr. Rosa Sigrist from the University of São Paulo in Brazil, examined 100 cases of filler-related vascular complications across multiple medical centers in Brazil, Colombia, Chile, the Netherlands, and the United States between May 2022 and April 2025. The findings, to be presented this week at the annual meeting of the Radiological Society of North America, reveal a concerning trend.
Ultrasound scans revealed absent blood flow in small vessels connecting arteries in nearly half of the cases studied. in a third of cases, blood flow was absent in major blood vessels. “These events can be devastating, causing tissue death and facial deformity if not treated promptly,” Dr. Sigrist explained.
The Power of Ultrasound Guidance
To proactively minimize these risks, Dr. Sigrist advocates for the widespread adoption of ultrasound imaging during filler injections. “If injectors are not guided by ultrasound, they treat based on where the clinical findings are and inject blindly,” she stated. “But if we can see the ultrasound finding, we can target the exact place where the occlusion occurs.”
Ultrasound allows clinicians to precisely map blood vessel locations before injecting, reducing the likelihood of inadvertently entering a vessel. In the event of a complication, ultrasound can also guide targeted treatment, minimizing the need for large doses of hyaluronidase – a drug used to dissolve fillers. This precision approach can lead to better outcomes and reduced side effects.
[An ultrasound scan of a patient’s lip shows absent blood flow (black areas located at the top, middle of the picture) in a segment of an artery. Meanwhile,red shows blood flow towards the ultrasound probe,while blue shows flow away from it.]
Ultrasound is a safe and non-invasive imaging technique, utilizing no ionizing radiation and posing no known health risks. The British Association of Aesthetic Plastic Surgeons (BAAPS) acknowledges the growing use of ultrasound, though it is indeed not yet considered standard practice.
“Mapping out the location of blood vessels undoubtedly provides valuable details ahead of treatment,” said Nora Nugent, president of BAAPS. “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.”
Calls for Increased Regulation
The potential for serious complications from dermal fillers is fueling calls for stricter regulation of the cosmetic procedures industry. The UK government is currently developing proposals to restrict high-risk procedures, such as Brazilian butt lifts, to “suitably qualified” healthcare professionals.
Clinics offering fillers and Botox will be required to meet stringent standards and obtain a license to operate. A public consultation is scheduled for early 2026, gathering input on the scope of these new regulations, with Parliament ultimately deciding on the final legislation.
These proposed changes reflect a growing awareness of the need to prioritize patient safety in the rapidly expanding field of aesthetic medicine. While dermal fillers can offer significant cosmetic benefits, the potential for devastating complications underscores the importance of skilled practitioners, advanced imaging techniques, and robust regulatory oversight.
