Experts in our field have previously issued guidelines to optimize the safety of filler injections. Despite the risks, a growing online trend of at-home self-injection of fillers in the face is putting patients in danger. We present our experience treating acute vascular injury in the United States. Based on the most recent literature, we share our protocol and its efficacy for this specific case. The fast-growing popularity of fillers in the beauty industry, and the availability of online content and videos on how to perform self-injections, likely give a false sense of safety to patients. Physician awareness is essential to prevent serious complications in our patient population. A strong knowledge of facial anatomy, the use of FDA approved products, and having the procedure performed by a trained medical professional are key elements to successful and safe filler injection.