Injectable fillers are associated with several complications that range from mild to severe. Patient's often experience pain, swelling, and bruising after filler injection. These symptoms are usually self-limited and resolve within a week. On the other end of the spectrum, vascular occlusion is a severe complication that can result in tissue necrosis and deformity, and even blindness or stroke. Although estimated to be ver y rare, occurring in <0.001% of cases, vascular occlusion should be considered in any patient with significant pain, erythema that transitions to duskiness, and/or excessive bruising. Vascular occlusion should be treated immediately with hyaluronidase injection, massage, and warm compresses. Patients with more severe presentations including vision loss or stroke should be sent to the emergency department where targeted hyaluronidase injection via interventional radiology can be considered. Although it is unclear how severe thispatient'scomplaints are over the phone, it is always appropriate to evaluate in the office. At this point, sending her to the emergency department is probably unnecessary in the absence of vision changes or stroke-like symptoms.