Does the vascular occlusion resolved?

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Dr. Maha ALFASSAM

MD, Kuwait

January 13th, 2026 20:26

Patient description

35 yr old female no past medical history 

Case description

I injected her lips 1 month ago and she came yesterday for botox and asked to retouched her lips so i did while injecting the upper lip patient developed hematoma more from inside the lip in the wet area , 

I used 30g needle injected vertically but i maybe went deep when i tried to add more volume to the lower border of the lip then i ended up contouring the vermillion borders horizontally as a final touch up 

I noticed the swelling and discoloration immediately with no pain (but this is maybe because if the lidocaine with thw filler) 

So i decided to dissolve the area affected and asked the patient to come to me next day morning which she did 

I found the bruises covered the whole lt side +the upper border of the lips 

So  i injected the hyaluronidase to the full lips and concentrated in the affected area i saw a little improvement in the inner hematoma in wet area but still not satisfied so asked her to come after few hours and injected the 2nd vial i feel the lips it self is better but im concerned about the bruise in the outer area is that occlusion also o just a bruise!?? 

I assessed capillary refill but i think im panicking couldnt tell is it normal or no 

No pain at all  experienced by the patient event next day 

The problem that this patient is travelling tomorrow morning and i dont know what to do ? Should i tell her to cancell her trip ??

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Dr. Thomas RAPPL

Plastic Surgeon, Austria

January 15th, 2026 16:01

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Dr. Maha ALFASSAM

MD, Kuwait

January 15th, 2026 15:31

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Dr. Maha ALFASSAM

MD, Kuwait

January 15th, 2026 15:25

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Dr. Foued MAKHLOUF

MD, France

January 14th, 2026 10:40

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Dr. Richard KOWALEWSKI

Anesthesiologist, Canada

January 14th, 2026 07:14

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Dr. Thomas RAPPL

Plastic Surgeon, Austria

January 14th, 2026 07:03

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Dr. Ronald FEINER

MD, Australia

January 14th, 2026 06:59

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Dr. Maha ALFASSAM

MD, Kuwait

January 15th, 2026 15:21

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Dr. Maha ALFASSAM

MD, Kuwait

January 14th, 2026 09:05

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Dr. Robyn D SIPERSTEIN

Dermatologist, United States

January 14th, 2026 05:40

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Dr. Maha ALFASSAM

MD, Kuwait

January 14th, 2026 08:59

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Prof Hussein Mohamed GHANEM

Dermatologist, Egypt

January 14th, 2026 01:23

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Dr. Fernando SILIKOVICH

MD, Argentina

January 13th, 2026 22:47

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Dr. Richard KOWALEWSKI

Anesthesiologist, Canada

January 13th, 2026 20:55

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Dr. Adriana POZZI

Plastic Surgeon, Italy

January 13th, 2026 20:53

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Dr. Maha ALFASSAM

MD, Kuwait

January 13th, 2026 20:58

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Dr. Anna AVALIANI

Cosmetic Surgeon, United States

January 13th, 2026 20:52

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