Abstract

Objectives: to highlight the role of ultrasound in the early diagnosis and management of vascular complications from hyaluronic acid fillers, using a clinical case of angular artery occlusion. It aims to demonstrate how ultrasound-guided treatment with hyalase can prevent tissue damage and to provide updated consensus recommendations for handling both early and late filler-related complications. Introduction: Achieving optimal patient outcomes starts with educating clinicians on using Ultrasound to prevent, diagnose, and manage complications from nonsurgical cosmetic procedures. This includes early detection and guided treatment of vascular occlusion and tissue ischemia from dermal filler events. Ultrasound helps assess reversibility with hyaluronidase when HA is involved. If not reversible or diagnosis is delayed, wound care becomes essential to prevent scarring or PIH. Aesthetic patients are vulnerable proper intervention matters. Materials / method: reviews a clinical case of Angular artery occlusion caused by hyaluronic acid fillers, demonstrating the role of ultrasound in diagnosis and hyalase in treatment. It also presents updated consensus recommendations for managing early and late complications related to HA fillers, highlighting the importance of timely intervention and guided care to optimize outcomes and reduce risks. Results: include specific recommendations for managing lower labial artery occlusion from HA fillers using ultrasound guidance. Key factors include patient, product, and technique considerations, along with detailed anatomy of the Angular and its variations. Effective ultrasound use and image interpretation are outlined. As filler-related wounds are under-addressed, the article offers basic wound care guidance and highlights essential management principles for post-ischemic injuries. Conclusion: Ultrasound is essential for early diagnosis and guided treatment of vascular complications from HA fillers. Knowledge of anatomy, product, and technique improves outcomes. When ischemia occurs, prompt use of hyalase and proper wound care can prevent lasting damage. Awareness of wound healing and management remains limited and should be emphasized to reduce long-term complications.