Facial Vascular Events and Tissue Ischemia: A Guide to Understanding and Optimizing Wound Care

The Complications in Medical Aesthetics Collaborative (CMAC) is a nonprofit organization established to promote best patient outcomes through educating clinicians in the prevention, diagnosis, and management of complications that can arise following nonsurgical cosmetic procedures. The organization is a global community sharing information, learning, experience, and data to promote best practices. This article explores how dermal filler vascular events can cause tissue ischaemia leading to a facial wound. Ideally, vascular events will be diagnosed early and amenable to reversal with hyaluronidase if caused by a cross-linked hyaluronic acid. If there is significant and extensive hypoxia to the area, there is delayed diagnosis, or the injected product cannot be reversed, the management should center around optimizing wound care. Both simple and complex wounds will benefit from good care. Patients seek aesthetic treatments to improve how they look and can be vulnerable to poor outcomes. Wounds, if not treated appropriately, can result in permanent scarring or other sequalae, such as post-inflammatory hyperpigmentation. There are many publications addressing vascular events in aesthetic practice, but providing optimal care for facial wounds is not addressed.