Face at Risks: Understanding Unqualified Filler Injections and Its Complication
- Dr. Jesse Chong
- Dec 27, 2023
- 8 min read
Updated: Jun 13
In recent years, dermal fillers Malaysia have become very popular for improving facial appearance. They are a quick and less invasive way to reduce wrinkles, add volume, and refresh the face without surgery.
However, many people often look for cheap dermal filler services and do not realize the risks of getting filler injections from unqualified or untrained individuals. Refer to the cost of Juvederm in Malaysia to get an idea of the standard price.
In this article, we explain why unqualified filler injections can be dangerous and what complications can happen.
Dark Side of Unqualified Practitioners
As dermal fillers become more popular, the risks from unqualified individuals offering these treatments are also increasing. These providers often do not have the necessary medical training, knowledge of facial anatomy, or emergency skills needed to perform injections safely. This puts patients at serious risk of complications.
Getting filler injections from someone who is not a trained medical professional can be very dangerous. The face contains many important structures such as nerves, blood vessels, and muscles. Only doctors or certified medical experts have the training and expertise to inject fillers safely.
If you’re looking for an experienced and certified aesthetic skin clinic in Kuala Lumpur, consider Dream Clinic! We do provide a proper consultation to explain what to expect and how to care for your skin after treatment.
a. Limited Understanding of Facial Anatomy
Non-medical practitioners usually lack the detailed medical training required to fully understand the complex structure of the face. Facial anatomy is not just a simple map; it is a dynamic and intricate landscape with many contours and vital structures.
Without this knowledge, the chance of causing unintended complications increases significantly. To help explain this, I like to use the concept of the “5 Rights” of dermal filler injection:
Right Site: Is the filler injected in the correct anatomical location?
Right Indication: Is the filler appropriate for that specific area and purpose?
Right Product: Is the chosen filler suitable for that particular site?
Right Dose: Is the amount injected correct, avoiding overfilling or unnatural results?
Right Route/Technique: Is the injection done using the proper technique to reduce risks?
Failing in any of these areas can lead to serious problems.
b. Inadequate Recognition of Individual Variability
Every person’s face is unique, and people respond differently to fillers. A qualified medical professional understands this variability and tailors the treatment accordingly. This personalized approach helps minimize the risk of complications and ensures better, safer results.
c. Lack of Emergency Treatment Training
Sometimes, complications can happen even when everything is done correctly. One of the most serious emergencies is vascular occlusion, where a filler blocks a blood vessel and cuts off blood supply to the skin.
Only trained medical professionals know how to recognize the early signs of this condition, such as sudden pain, pale or discolored skin, and can provide immediate treatment following established protocols. Quick action is essential to prevent permanent damage.
Complications Associated with Unqualified Filler Injections
When fillers are injected by unqualified or inexperienced practitioners, the risk of serious complications rises dramatically. These complications are not just minor side effects—they can lead to permanent damage, disfigurement, or even life-threatening conditions. Understanding these risks is crucial to making informed decisions about your treatment.
Vascular Occlusion (Blocked Blood Vessels)
Among the most serious complications is vascular occlusion, which occurs when filler material blocks a blood vessel, cutting off blood supply to the skin and underlying tissues. This can happen in two ways:
Intravascular Injection: The filler is accidentally injected directly into an artery.
Extravascular Compression: The filler presses on a blood vessel from outside, reducing or blocking blood flow.
Without immediate treatment, vascular occlusion can cause skin necrosis—the death of skin tissue due to lack of oxygen—and may result in permanent scarring or tissue loss. In extreme cases, if blood flow to the eye is affected, it can cause blindness.
Warning Signs of Vascular Occlusion
Recognizing the early signs of vascular occlusion can save your skin and even your vision. These signs can appear during or shortly after the injection and include:
Severe Pain: Unlike normal injection discomfort, vascular occlusion causes sharp, intense pain either immediately or within hours after treatment. If you experience sudden or worsening pain, alert your practitioner immediately.
Blanching (Pale or White Skin): The affected area may turn pale or white due to reduced blood flow. This blanching can be fleeting at first but may become irregular and persistent if untreated.
Dusky or Purple Discoloration: Hours later, the skin may develop a purplish or bluish hue as unoxygenated blood accumulates. This discoloration can look like bruising but differs because bruises do not blanch.
Coolness: The skin in the affected area may feel noticeably cooler than surrounding areas due to poor circulation.
Delayed Capillary Refill: When you press on the skin, it takes longer than two seconds to regain its normal color, indicating compromised blood flow.
If you notice any of these signs, seek emergency medical care immediately. Early intervention with treatments such as hyaluronidase injections (which dissolve hyaluronic acid fillers), warm compresses, and massage can restore blood flow and prevent permanent damage.
Consequences of Delayed Treatment
If vascular occlusion is not treated promptly, skin tissue can begin to die, leading to:
Open sores and ulcers
Severe scarring and disfigurement
Secondary infections that can worsen the condition
In rare cases, blindness or stroke may occur if blood flow to critical areas is blocked
Infection
One of the most common and dangerous complications from unqualified filler injections is infection. When injections are performed in non-sterile environments or with contaminated products, bacteria can enter the skin and cause infections ranging from mild redness and swelling to severe abscesses requiring hospitalization.
Infections can delay healing, cause scarring, and in rare cases, spread to deeper tissues or the bloodstream, posing a systemic threat.
Allergic & Inflammatory Reactions
Though rare, allergic reactions to fillers can be life-threatening. Without proper allergy testing beforehand, some patients may develop:
Angioedema: Rapid swelling beneath the skin, which can affect breathing if it involves the throat.
Anaphylaxis: A severe, systemic allergic reaction requiring immediate emergency treatment.
Chronic inflammatory reactions may also occur, causing persistent redness, swelling, and the formation of lumps or granulomas that are difficult to treat.
Unsatisfactory Cosmetic Results
Unqualified injectors often lack the skill to achieve natural and balanced results. This can lead to:
Uneven or lumpy skin texture
Overfilled or distorted facial features
Asymmetry and unnatural appearance
Long-term damage requiring corrective surgery
In summary, unqualified filler injections are not worth the risk. The potential for severe complications like vascular occlusion, infection, allergic reactions, and poor cosmetic outcomes is high. Always choose a licensed medical professional with proper training and emergency preparedness to ensure your safety and satisfaction.
Areas of Caution
It is important to understand that there are no completely safe areas on the face when it comes to dermal filler injections. Every part of the face contains delicate structures, including blood vessels, nerves, and muscles, which require careful handling. Therefore, all injection sites must be treated with the utmost respect and precision.
Why the Midline Requires Extra Care
Special attention is needed when injecting along the midline of the face—the central vertical area including the forehead, glabella (between the eyebrows), nose, and upper lip. This region is particularly risky because it is supplied by arteries with limited collateral blood flow. This means if a blood vessel is blocked here, there are fewer alternative routes for blood to reach the tissue, increasing the chance of serious complications like skin necrosis or even blindness.
Key Danger Zones to Be Aware Of
Certain facial areas carry a higher risk of vascular complications due to their complex and vulnerable vascular anatomy:
Forehead and Glabella: These areas have a dense network of small arteries (supratrochlear and supraorbital arteries) lying close to the skin surface. Injecting fillers here risks blocking these vessels, which can cause skin ulcers, scarring, or in rare cases, blindness. Alternative treatments like Botox or skin boosters are often safer choices in this region.
Nose: The nose’s vascular system connects directly to the arteries supplying the eyes. Filler injections here can accidentally enter these vessels, causing vascular occlusion and potentially leading to tissue death or blindness. Prior trauma or surgery can also alter blood flow, increasing risks.
Tear Trough (Under-Eye Area): While not as high-risk for vascular occlusion as the nose or forehead, the tear trough is a difficult area to treat due to thin skin and delicate tissues. Poor technique can cause bruising, swelling, or lumps.
Nasolabial Folds: These folds run from the sides of the nose to the corners of the mouth and are supplied by branches of the facial artery. Incorrect injections here can block blood flow, causing tissue damage or scarring.
Lips and Perioral Area: The lips have a rich blood supply from the labial arteries. Overfilling or injecting too quickly can cause vascular compromise, leading to painful tissue loss and permanent scarring.
Temples: The superficial temporal artery runs through this area. Vascular occlusion here can cause severe pain, skin necrosis, and even blindness if filler migrates to the ophthalmic artery.
Making Informed Choices: Finding the Right Professional for Cosmetic Injections
We encourage you to read our previous article, “Safeguarding Beauty: Choosing the Right Professional for Your Aesthetic Journey” where we highlight real cases of patients who suffered severe complications—including permanent disfigurement and even death—after receiving treatments from unlicensed beauticians.
The complexity and risks of these danger zones underscore why only qualified and experienced medical professionals should perform filler injections. They have the detailed anatomical knowledge, skill, and emergency preparedness to minimize risks and manage complications swiftly if they arise.
Your face deserves the utmost care and expertise. Here are essential tips to ensure safe and effective filler treatments:
Seek Licensed Medical Professionals: Verify credentials and experience before proceeding.
Consult Thoroughly: A qualified practitioner will assess your facial anatomy, discuss realistic expectations, and tailor the treatment plan.
Avoid Bargain Treatments: Extremely low prices often indicate compromised quality or unqualified providers.
Understand the Risks: Be informed about potential complications and how they are managed.
Follow Post-Treatment Instructions: Proper aftercare minimizes side effects and promotes healing.
Conclusion: Safeguarding Your Beauty Journey
Every face is unique, and it is crucial to entrust your skin only to trained medical professionals. This ensures that each treatment is carried out safely and effectively, significantly reducing the risk of complications.
If you have any questions about anti-aging treatments or want expert advice, make your appointment with us now at Dream Clinic, your trusted skin specialist in Penang. And if you have friends who are also passionate about beauty, feel free to share this article to help them receive the safest and best treatments to achieve their aesthetic goals.
Don’t just dream it! Live it!
We can’t wait to welcome you at Dream Clinic!
FAQs
How can I verify a practioner is qualified to perform dermal filler injections in Malaysia?
You can check if the practitioner holds a valid Letter of Credentialing and Privileging (LCP) issued by the Malaysian Ministry of Health and is listed in the National Registry of Registered Medical Practitioners Practising Aesthetic Medical Practice.
What should I look for during a consultation to ensure safe dermal filler treatment?
A qualified practitioner should conduct a thorough facial assessment, discuss your medical history, explain the treatment plan including risks, obtain informed consent, and tailor the filler type and technique to your individual anatomy.
Are there any legal protections or recourse if complications arise from filler injections done by unqualified individuals?
Treatments performed by unlicensed or unqualified practitioners may not be covered by medical malpractice laws, making it difficult to seek legal recourse. Reporting such cases to health authorities can help protect others.
What emergency measures should a qualified practitioner be prepared to perform during filler complications?
They should be trained to recognize and promptly treat vascular occlusion, including administering hyaluronidase to dissolve hyaluronic acid fillers and managing other adverse reactions to minimize tissue damage.
How does individual facial anatomy variability affect the outcome and safety of dermal filler injections?
Each person’s facial structure and vascular network differ, so a skilled medical professional must customize the injection technique and product choice to avoid complications and achieve natural results.
