06/18/2026
Aesthetic Medicine is Minimally Invasive — Not Minimal Risk.
The recent death of Kendal Ascher following a dermal filler procedure is a devastating reminder that severe complications from aesthetic injections are rare — but they are real.
Even the most reputable, experienced injectors can face catastrophic outcomes.
For years, we considered skin necrosis from a vascular occlusion to be the “worst case scenario.” As treatment areas expanded into higher risk zones — nose, forehead, temples — we began to see reports of visual disturbances and even blindness.
Now, we are hearing about fatal pulmonary embolism associated with filler treatments. After a literature search there are only a handful of articles that reference death from PE - related to location of the larger blood vessels and the excessive volume of filler used to achieve the desired outcome.
Have our practices evolved faster than our safety standards? We need to ask ourselves these questions:
• Are we practicing within our scope
• Are we qualified to treat off face and high risk areas
• Are we prepared to recognize and manage complications
• Do our discharge instructions include red flag symptoms of pulmonary distress
Aesthetic providers must understand that high risk and off face procedures require advanced anatomical training, cadaver based education, and competency assessment — not a single workshop or online module.
Aesthetic medicine is minimally invasive — not minimal risk. Safety is not a tagline. It is a professional obligation.
Reference:
Bingoel, A.S., Dastagir, K., Neubert, L. et al.(2022) Complications and Disasters After Minimally Invasive Tissue Augmentation with Different Types of Fillers: A Retrospective Analysis. Aesth Plast Surg 46, 1388–1397 (2022).
Shaheen, S., Al Habbaa, A., Riad, M. S.et al. (2023). Fatal pulmonary embolism following injectable gluteal filler usage: A case report. The Egyptian Heart Journal, 75, 83.