56.3%
of 48 published filler blindness cases (2015 to 2018) followed injection of the nose, the most common site.
Beleznay et al., Aesthet Surg J 2019. Literature review of 48 cases.Chair-side protocol for HA and CaHA fillers
Vascular Occlusion Protocol
A one-page workup card, a step-by-step algorithm, and a fully referenced evidence page for the complication every injector trains for and hopes never to see. Built by a physician from the primary guidelines.
- 3 pages
- 2 fillers: HA and CaHA
- 8 PubMed references
Minutes matter. Searching for the protocol should not take any.
When blanching, livedo, or a slow capillary refill shows up mid-treatment, you need the dose, the endpoint, and the eye pathway in front of you, not in a webinar you watched last year.
This protocol puts the HA high-dose pulsed hyaluronidase steps and the CaHA expert consensus side by side, with every number traced to its source.
What the evidence shows
20.8%
of those cases had complete visual recovery. No treatment was consistently successful.
Beleznay et al., Aesthet Surg J 2019. Literature review of 48 cases.1,500 U
hyaluronidase per cycle across the whole ischemic area in the CMAC guideline for HA occlusion, repeated until capillary refill normalizes.
Murray et al., J Clin Aesthet Dermatol 2021. Expert guideline.6 rabbits
make up the only in vivo study of hyaluronidase for CaHA occlusion. Human efficacy is unproven, and the protocol says so.
Rowland Payne et al., Facial Plast Surg 2026. Animal model, 7 days.There are no randomized trials of occlusion rescue. The protocol tells you which steps rest on guidelines, case series, or animal data.
What's inside
- Page 1
Workup card
Signs by timing, highest-risk sites, the HA and CaHA rescue protocols, what not to do, an emergency kit check, and what to document.
- Page 2
Algorithm
A decision chart from suspicion to resolution: the eye and neuro emergency branch, HA versus CaHA pathways, reassessment loops, and late presentation.
- Page 3
References
Eight sources with PubMed links, what each one supports, and a plain-language evidence level note, including where guidelines disagree.
Who it's for
- Physicians, NPs, PAs, RNs, and dentists who inject HA or CaHA
- Medical directors writing or updating an emergency protocol
- Practices that want the same steps posted in every treatment room
What you get
- 3-page PDF, US Letter, prints cleanly in color or grayscale
- HA and CaHA protocols on one card, with doses in units
- Algorithm for the wall or the crash cart binder
- 8 references, each with a PubMed link and study type
Choose your license
Individual
$29
One practitioner. The full 3-page protocol PDF.
Buy nowFor practices
Practice license
$69
Up to 5 staff in one practice. Print it for every treatment room.
Buy nowSecure checkout by Stripe. Your download opens right after payment, and Stripe emails your receipt. NJ sales tax is added at checkout where applicable.
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Questions
Is this a substitute for training?
No. It is a chair-side reference for practitioners who are already trained in filler complications. Know your local protocol and when to transfer.
Why do HA and CaHA differ?
Hyaluronidase dissolves HA but not CaHA. The CaHA steps come from a separate 17-member expert consensus and are labeled as such.
Is hyaluronidase use here on-label?
No. Hyaluronidase for vascular occlusion is off-label. Doses are taken directly from the cited guidelines; US products differ in concentration, so dose by units.
Is this CME?
No. It is educational content for licensed practitioners and does not award CME credit.
Can my whole team use one copy?
The Individual license is for one practitioner. The Practice license covers up to 5 staff in one practice.