Objectives: "Vascular Compromise Following Lip Filler Injection" https://www.imcas.com/en/academy/alert/injectables/3379/vascular-compromise-following-lip-filler-injection This alert submission resulted in a remarkable 55 collegiate responses and 378 collegiate views, exemplifying the intense discussion process that provides an illuminating exchange of ideas and valuable assistance to the submitting colleague. Introduction: IMCAS Alert submissions can be a fertile forum for collegiate discussion and debate, providing the colleague, who submits a case of concern, some management options that may greatly assist in resolving the case. Materials / method: In this particular case, responses and discussion incorporated many issues and management strategies including; utilisation of hyaluronidase , steroids , hyperbaric oxygen, capillary return signs. ultrasound interrogation, choice of needle size, possibility of decanting of fillers into insulin syringes with 31g needles & the value of an emergency kit for vascular occlusions.......... Results: The colleague who submitted the perplexing case acknowledged the value of respondents' management suggestions. Conclusion: A remarkable case discussion and exchange of ideas that benefited not only the submitting colleague but indeed all participating respondents & also the many colleagues who followed the discussion as it evolved.