Question 1

Do you have hyaluronidase on-site for emergency vascular occlusion management?

Accepted Answer

The answer must be "yes, we have it here, in this room, ready to use." Nothing less is acceptable. Hyaluronidase is the antidote for a vascular occlusion, which is when filler accidentally blocks a blood vessel, stopping blood flow to the skin or, in the worst cases, to the eye. It can cause permanent skin death or blindness within hours without immediate treatment. "We can get it if needed" or "we have a pharmacy nearby" are not acceptable answers. If they are vague about this, you should leave that appointment.

Question 2

Are you trained in vascular occlusion recognition and have you managed a complication before?

Accepted Answer

A good answer sounds like: "Yes, I have done formal vascular complication training. The signs I watch for are immediate skin blanching, a white or grey patch at the injection site, followed by a purple mottled pattern and severe pain. If I see that, I flood the area with hyaluronidase immediately and call for emergency support if vision is affected." They should name the warning signs without you having to prompt them. If they have personally managed a complication and describe it calmly, that is reassuring, not alarming. An injector who denies complications ever happen, or who becomes defensive at the question, is either inexperienced or dishonest.

Question 3

What volume do you plan to inject, and in how many sessions?

Accepted Answer

A good answer sounds like: "Based on your anatomy, I would suggest starting with one syringe per side, then reassessing at four weeks once the swelling has settled before deciding whether you want more." Conservative volume in a first session is a sign of good clinical judgment, not under-confidence. If someone suggests three or more syringes in a single first visit without a detailed explanation tied to your specific anatomy and degree of volume loss, that warrants scrutiny. Filler complications and migration risk increase with volume, and you can always add more at a follow-up.

Question 4

What injection technique do you use, cannula or needle, and why for this area?

Accepted Answer

A good answer sounds like: "For the cheeks I often use a cannula, which is a blunt-tipped instrument rather than a sharp needle. It cannot pierce a blood vessel the same way, so the vascular risk is lower for high-risk zones. For a precise structural point I may switch to a fine needle." The key is that they explain the choice based on your anatomy and the risk profile of the area, not just habit. If they say "that is just how I always do it," they are not thinking about your specific anatomy and the vascular map beneath it.

Question 5

Can you show me a simulation or aged photo of what this area could look like?

Accepted Answer

They should show real photos from their own patient records, ideally someone with a similar bone structure and degree of volume loss to yours, and be honest about what filler can and cannot achieve. A good practitioner will also tell you when surgical options would give you a more meaningful result than filler, rather than selling you a series of syringes. If they rely on stock photos, manufacturer before-and-afters, or curated social media content, you cannot assess whether their own hands produce results that match your situation.

Question 6

What are the early signs of vascular occlusion I should watch for after I leave?

Accepted Answer

A good answer is specific and serious: "Watch for a white or grey patch on your skin, anywhere near where I injected, that does not flush back to pink within a minute. Then a purple, mottled pattern. And pain that feels out of proportion to the treatment. Any of those, call me immediately. If you notice any change in your vision, skip calling me and go straight to the emergency room because that needs immediate specialist care." Vascular occlusion that cuts off blood to the skin can cause permanent scarring and tissue death. Occlusion affecting the blood supply to the eye can cause permanent blindness. "Just watch for swelling" is not an adequate briefing.

Question 7

What is your refund or revision policy if I am unhappy with the result?

Accepted Answer

A good answer sounds like: "We do a complimentary review at two to four weeks. If there is asymmetry or an outcome you are not happy with, we discuss whether a small amount of additional filler or dissolution with hyaluronidase is the right fix, and we do not charge you for that correction." This tells you they consider the outcome their responsibility, not just the procedure. Clinics that tell you all sales are final, offer only discounts on your next appointment, or make you feel difficult for asking are not standing behind their work.

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