Inadvertent intravascular injection of any dermal fillers, including calcium hydroxyapatite (CaHA) ones, can lead to serious adverse events, including soft tissue necrosis, gross scarring, and impaired function (loss of vision). In the case of intra-arterial filler injection, immediate action is required to achieve optimal results, but the rarity of this adverse event means that many physicians may never have encountered it and therefore do not have a clear understanding of the action algorithm. Vascular complications such as ischemia, embolism, and vascular occlusion in contouring procedures remain the worst “nightmare” of the aesthetic medical professional. The objective of this article is to describe a rare clinical case of subchondral artery thrombosis (a. submentalis) after a volumetric modeling procedure in combination with vector lift, as well as a cosmetologist’s approach to recognition and treatment of vascular abnormalities after inadvertent intravascular CaHA injection. Knowing the algorithm for the management of such patients and the availability of recommended medications to treat vascular complications related to CaHA-based dermal fillers is essential for the timely and effective management of complications.