Reducing the risk of occluding the columella artery

Dr Tim Pearce

August 8, 2018

Over the weekend Dr Tim Pearce was notified of a fellow clinician that unfortunately experienced his first vascular occlusion of the columella artery whilst treating a client.

Despite the clinician dealing with it very well, Dr Tim decided to do a Facebook Live to help people both try and prevent them from happening.

He has also provided some tips on how to manage them if they do happen.

How to prevent an occlusion from happening

There are certain injection techniques that can be used to make treatment as safe as possible, especially when injecting the philtrum.

Despite being risky areas to treat, it is important to treat the philtrum column and vermillion border. When treated well, this can create the most precise and defined result.

These injections are aesthetically required in helping make the result look as natural as possible. Treating the philtrum column largely prevents your client from looking false and duck mouthed.

The Anatomy

It is very important that whenever anyone has a lip treatment that you ask them if they have a pain in their nose afterwards. The columella artery goes from the lips and up to the tip of the nose.

It is important to check the tip of the nose and the philtrum for capillary refill when looking for an occlusion.

Another point to be aware of is the shape of the philtrum. In younger people, the philtrum tends to be curved, and as we age the philtrum becomes straighter.

A curved philtrum is riskier to treat as it is no longer the same shape as the needle, so you are more likely to hit an artery. One way to make this safer is to not go unnecessarily deep.

Aspirating

In risky areas Dr Tim recommends aspirating multiple times. This is because you may aspirate once and it may come back negative, yet as you move the needle you could still hit an artery if your needle is parallel to it.

Aspirating is a widely debated as many believe it is time consuming and causes unnecessary pain for your clients.

Dr Tim says

‘Lots of people think there’s no point doing it because it’s not 100% effective. I always say that’s a bit like a seat belt. It’s also not 100% effective but it is certainly better than nothing’.

Managing an occlusion

One of the most important aspects about managing an occlusion is making sure the patient has your full support and attention.

It requires a lot of effort on behalf of the practitioner, such as multiple visits and treatments.

However, it is worth it to make sure you are ensuring the safety and care of the individual.