Managing Vascular Occlusions: Insights from Dr Holbrook

 The content of this blog is designed and intended for the education of Healthcare Professionals

The art of bringing a change to one’s appearance through non-surgical cosmetic procedures calls for expert precision and knowledge. However, even in the hands of the most skilled professional, complications can arise. 

Fresh Members recently had the opportunity to dive into an educational session with our very own Dr John Holbrook, on managing vascular occlusions (VOs) in aesthetic treatments.

Vascular Occlusions: A Fear for Practitioners 

"The vessels in our bodies, particularly in our face, are all connected," Dr Holbrook emphasized during the session. Vascular occlusion, a rare but serious complication, can result from dermal filler treatments, with incidences being roughly 1 in 10,000. While low, the risk is real and can result in serious complications if not managed promptly and appropriately.

To minimise the occurrence of VOs, practitioners often adopt standard procedures. For example, the idea of only injecting in 'safe' points has always been conventional. However, it's not a course that Dr Holbrook advocates,"There's no safe...everywhere can be risky.”

The Treatment Approach

When an occlusion is suspected or occurs, the first course of treatment is to call in an expert immediately.

Another critical part of the immediate response is injecting hyaluronidase into the affected area, an enzyme that can potentially reverse the occlusion by breaking down the filler.

Dr Holbrook shared through his personal experience, how he managed a rare, yet serious VO that affected a patient's chin and tongue due to a midline filler injection in the chin.

"We fixed it in a day… and it didn't require any further interventions," Dr Holbrook recalled about one of the most complex cases he'd managed. Despite immediate action, the patient still experienced extreme pain, challenging the process of treatment. Utilizing hyaluronidase and maintaining an open line of communication with other specialists, the case was successfully navigated.

It is important to emphasize the need for persistence in managing occlusion. Dr Holbrook noted, "Just because it has always been okay before, doesn't mean it will be okay this time."

He reiterated that every treatment comes with its own level of uncertainty and risk.

The need to remain constantly cautious and prepared for any event is one that resonated deeply with our Members. In the face of such potential complications, the importance of patient well-being remains at the forefront. 

The session was a wealth of information on managing vascular occlusions, and a testament to Dr Holbrook's persistent, dynamic, and patient-first approach. 

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