Complications of lip filler include initial bruising and swelling (can last a week or so). Reactivation of cold sores, Bacterial infection and delayed onset nodules (lumps), but both fortunately rare. 
The most feared complication however amongst practitioners is a vascular occlusion, when filler is injected into a blood vessel. 
Whilst complications are more likely with inexperienced practitioners, vascular occlusion can happen to anyone, and the key to preventing long term complications is prompt effective treatment. 
The Aesthetic Complications Expert group (ACE) Offer a phone help line for members wanting advice, and they report receiving daily calls from practitioners who suspect they have caused a vascular occlusion. 
Whilst this frequency of potential occlusion is disturbing, what is more disturbing is the story of the client whose photos are above. She received filler treatment in Glasgow, and when she developed pain afterwards she was told by her aesthetic practitioner to go to casualty. Although this seems to show a lack of responsibility by the practitioner This is also the recommendation of the NHS England website.  
Unfortunately staff in casualty were not experienced in treating aesthetic emergencies, and apparently rather than trying to resolve the occlusion decided to let it take its course (ie let tissue in her upper lip and nose die) and then offer plastic reconstructive surgery. 
Fortunately the client found another practitioner (Michelle McLean) who was a member of the ACE group who offered prompt effective treatment and managed to save all but the tip of the clients nose. 
Whilst the staff at the Casualty that the lady attended could be criticised for failing to provide appropriate treatment in an emergency, it has been pointed out in an article published early last year that although the public is told if they have a complication to go to casualty, actually NHS medical staff don’t undergo any training in the treatment of aesthetic complications.  
The article discussed another case, that of a lady with persistent ulceration of her lip that her GP thought was cancer. The lady concerned didn’t want to say that she had actually had lip filler, and it was almost by chance that the correct diagnosis was eventually realised, and appropriate treatment given rather than an inappropriate operation being performed. 
So what’s the take home message? 
The incidence of complications after Filler is still fortunately low, but you are more likely to have a problem if you go to someone who is inexperienced (models wanted, cheap fillers etc). Make sure your practitioner explains potential complications and knows how to treat them (they should be a member of the ACE group) and if they are not a doctor or prescribing nurse I would be concerned that they are less likely to have access to any emergency drugs required. 
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