Reticulated Livedoid Skin Patterns After Soft-Tissue Filler Related Vascular Adverse Events

The presentation discusses reticulated livedoid skin patterns observed following vascular occlusion due to soft-tissue filler treatments. It highlights the treatment of 136 cases through ultrasound guiding, focusing on the hypothesis of intravascular filler occlusions and arterial spasms. The anatomical explanation involves arteries in the face supplying superficial fatty layers through perforators, which can aid neighboring arteries in cases where one is compromised. The seminar details how vascular occlusion leads to necrosis, visible on ultrasound, as a lack of microvascularization beneath the affected skin. Treatment typically involves injecting hyaluronidase to restore capillary function, showcasing the healing patterns and improved microvascularization seen shortly after intervention. The speaker emphasizes the characteristic 'marbling' skin pattern attributable to vascular occlusion, which is consistent across different areas of the face, providing a useful guide for differentiating between bruises and actual vascular occlusions. Finally, a vascular ultrasound-guided protocol is available for practitioners to aid in managing such complications.