The risk profile of cross-linked hyaluronic acid (HA) injections is primarily determined by the anatomical region of injection and the targeted tissue plane. From the perspective of vascular complications, both the depth of injection and accurate selection of the anatomical plane are of critical importance.

Various techniques for scar filler applications have been described in the literature and clinical practice. In this context, the Repetitive Superficial Scar Filler Technique, which I apply in my clinical practice, is based on performing injections at the superficial dermal level through repetitive microinjections. In the tissue planes targeted by this technique, major branches of the arterial supply to the face are not present, thereby eliminating the risk of intravascular injection and related serious complications.

Based on my clinical experience, between August 2023 and February 2026, more than 600 scar filler sessions were performed, and cross-linked hyaluronic acid injections were administered to over 150,000 acne scars. Throughout this period, no intravascular complications were observed.

In conclusion, when performed with proper anatomical planning and appropriate technique, scar filler treatment can be considered a medical aesthetic procedure with a high safety profile. However, as with all injectable procedures, overall safety is largely dependent on the practitioner’s experience and detailed knowledge of anatomy.