Delayed vascular occlusion

Although the actual process for delayed commencement of presentation is unknown, various theories have been proposed:

  1. Hyaluronic acid fillers and their hydrophilic nature in drawing water molecules might cause delayed swelling after therapy and subsequent exterior vascular compression.
  2. An embolus may also cause obstruction in an area with diminished collateral circulation. In such cases, it is possible that there is no manifestation of initial symptoms. However, symptoms start to appear more aggressively with time as soon as the collateral supply becomes more diminished and fails to provide for the respective area of the skin.
  3. Another potential cause of delayed vascular occlusion can be an intra-arterial injection, which does not directly cause vascular occlusion, but it generates a focal point for the aggregation of platelets, eventually precipitating into occlusion.
  4. Intra-arterial injection may occur at a larger vessel or a bifucation. This can eventually dislodge and occlude a terminal branch of the vessel.