For licensed aesthetic professionals only. Guidance here supports — and never replaces — your clinical judgement. Do not upload identifiable patient data.
Sharing a quick checklist I teach: immediate blanching, disproportionate pain, dusky/mottled skin, delayed capillary refill. What early signs have caught you out, and what's your first-line step before hyaluronidase?
The ones to act on immediately: disproportionate or increasing PAIN, blanching/pallor that doesn't fit normal blanching, a dusky or mottled (livedo) skin change, and delayed capillary refill. Don't wait for certainty — if you suspect an occlusion, stop, and move to your emergency protocol (flood the area with hyaluronidase, follow your training, and escalate). Have your complication kit and a written pathway in the room before you ever inject filler.
'Act on suspicion, don't wait for certainty' is the line that stuck with me from training. Time is tissue.
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