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A senior Estée Lauder executive died suddenly in February after cosmetic filler triggered a pulmonary embolism, the New York City medical examiner announced this week.

A pulmonary embolism happens when an object, in this case filler, blocks an artery in the lungs. This blocks blood flow, starving the entire body of oxygen. Kendal Ascher, 56, died of acute respiratory failure after his pulmonary embolism.

But how would that filler end up in the blood stream in the first place — and are others who get filler at risk for this tragic complication?

According to Dr. Kenneth Mark, a cosmetic dermatologist and faculty member of the Allergan Medical Institute who did not treat Ascher, it’s possible the filler was accidentally injected directly into a blood vessel.

This is “extremely rare” in facial filler and “much more classically associated with larger volume injection of fat in the buttocks,” Marks told The Post.

A 26-year-old woman died of exactly this 18 hours after getting filler in her behind. Gluteal fat grafting is one of the deadliest cosmetic surgical procedures.

Cosmetic filler is an injection of a gel-like substance, like hyaluronic acid or fat from another part of the body, to “fill” creases and lines and add volume to places that sink or shrink over time, like in cheeks and lips.

Dermal facial fillers are considered very safe — as long as they’re “performed by a board-certified plastic surgeon or dermatologist with extensive experience and knowledge of facial anatomy,” said Dr. Lyle Leipziger, Chief of Plastic Surgery at North Shore University Hospital and LIJ Medical Center.

That’s good news for the over 5 million people who get facial fillers a year.

There are some normal side effects, like swelling and bruising. “Even if someone just gets poked [with] the needle, without any filler injection, they can get some reactive swelling,” Marks said. “When filler is injected, it is normal to get swelling that can last 24 to 72 hours.”

That’s good news for the over 5 million people who get facial fillers a year.

Leipziger says redness and tenderness at injection site are also normal.

Things can still go wrong. “There are always inherent risks and every patient can have a different anatomy,” Marks said.

The rarest and most concerning complication, both doctors agree, is vascular occlusion. This is when fillers are accidentally injected into a blood vessel, blocking facial blood flow. This could be what preceded Ascher’s death.

This might cause pain and discoloration. If caught quickly, it can be reversed with an injection of an enzyme (Hyaluronidase) to dissolve the filler, Leipziger explained.

If not treated, this can lead to skin necrosis, pulmonary embolism or blindness, Marks said. Certain areas such as the temples, frown areas and lips are at higher risk than others.

Leipziger and Marks agree that the best way to protect yourself is to find an experienced, board-certified plastic surgeon or dermatologist.

“There are way too many people performing cosmetic procedures including injections without the proper training and experience,” Marks said. “This has led to fillers getting a bad stigma not infrequently from the wrong filler and too much filler being injected into the wrong places.