Vascular Complications Following Hyaluronic Acid Filler Injections: Current Concepts in Recognition, Management and Prevention – A Narrative Review

Hyaluronic acid (HA) fillers are among the most commonly performed minimally invasive procedures in aesthetic medicine worldwide [4,5]. Although generally considered safe, they may lead to rare but potentially severe vascular complications, including tissue ischemia, skin necrosis, and vision loss [6,10]. The aim of this study is to provide a comprehensive review of the current literature regarding the pathophysiology, clinical presentation, management, and prevention of vascular complications associated with HA filler injections. A narrative literature review was conducted, including review articles, retrospective studies, expert consensus statements, and case reports. Publications addressing the mechanisms, diagnosis, and management of vascular complications were analyzed. Vascular complications primarily result from inadvertent intravascular injection or extravascular compression, leading to impaired tissue perfusion [4,7]. Timely identification of vascular compromise and immediate therapeutic intervention are essential for optimizing clinical outcomes [20,21]. Despite the growing body of literature, significant variability in treatment recommendations persists, and standardized guidelines remain lacking. Further high-quality research is necessary to improve the safety of aesthetic procedures.