Cosmetic Facial Fillers and Severe Vision Loss

Carle, Michelle V; Roe, Richard H.; Novack, Roger L.; Boyer, David S.

doi:10.1001/jamaophthalmol.2014.498

Cited by 96 publications

(51 citation statements)

References 5 publications

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“…It can occur if injection into an artery causes retrograde flow proximal to the central retinal artery's branching point, with the filler then being carried forward with the blood flow, eventually causing obstruction . Thus, irreversible vision loss should be added to the list of potential complications associated with injection of cosmetic facial fillers, regardless of where the filler is injected in the face …”

Section: Adverse Effectsmentioning

confidence: 99%

“…32,41 Thus, irreversible vision loss should be added to the list of potential complications associated with injection of cosmetic facial fillers, regardless of where the filler is injected in the face. 42,43 Treatment. We recommend avoidance of critical anatomical areas, aspiration, slow injection technique and avoidance of excessive quantities of HA, with close attention paid to any pain or discolouration (i.e.…”

Section: Potential Adverse Eventsmentioning

confidence: 99%

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Consensus statement on prevention and management of adverse effects following rejuvenation procedures with hyaluronic acid‐based fillers

Philipp‐Dormston¹,

Bergfeld²,

Sommer³

et al. 2017

Acad Dermatol Venereol

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Facial fillers play an important role in the correction of facial changes associated with ageing. They offer quick treatments in the outpatient setting with minimal subsequent downtime that provide predictable, natural-looking, long-lasting results. Adverse reactions after hyaluronic acid injections tend to be mild or moderate and rather temporary. However, as with all injected or implanted biomaterials, severe adverse events can occur and patients must be fully informed of potential risks prior to undergoing treatment. A panel of experts from Germany (D), Austria (A) and Switzerland (CH) developed recommendations, and this study provides the 'DACH Consensus Recommendations' from this group specifically on the use of hyaluronic acid fillers. The aim is to help clinicians recognize potential risks and to provide guidance on how best to treat adverse events if they arise. Contraindications to hyaluronic acid fillers are also detailed, and ways to prevent adverse events occurring are discussed. Hyaluronic acid-based products are claimed to be very close to an ideal tissue augmentation agent; nevertheless, profound medical, anatomical and product knowledge are of paramount importance to minimize the occurrence of adverse reactions.

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Section: Adverse Effectsmentioning

confidence: 99%

Section: Potential Adverse Eventsmentioning

confidence: 99%

Consensus statement on prevention and management of adverse effects following rejuvenation procedures with hyaluronic acid‐based fillers

Philipp‐Dormston¹,

Bergfeld²,

Sommer³

et al. 2017

Acad Dermatol Venereol

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“…Carle et al [20] described 3 cases of blindness due to dermal fillings in the forehead region consisting of autologous fat, hyaluronic acid, and polylactic acid. The occlusion of the central artery of the retina, which was affected in all 3 cases, was performed through the rich anastomosis in this region of the branches of the external and internal carotid arteries.…”

Section: Discussionmentioning

confidence: 99%

Influence of the Topographic Vascular Distribution of the Face on Dermal Filler Accidents

et al. 2019

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Objective: Dermal fillers are an important tool in the field of aesthetic dermatology. Fillers are relatively noninvasive and easy to use but are not free of secondary complications. The main complications are vascular and are due to either the compression of an artery or the direct introduction of the product into the arterial lumen. The aim of this study is to provide an overview of the vascular territories of the face to avoid many possible complications when using facial fillings. Anatomical localization of the main arterial supply to the face has been described to assess the risk of vascular injury. Methods: The authors dissected 17 hemifaces of embalmed adult cadavers that had previously been injected, through the common carotid artery, with latex containing a red dye. Results: A topographic distribution was generated by facial regions following a clinical approach from where the facial fillings were placed and related to the pathways of the arteries. Following these criteria, we established 8 topographic regions (I–VIII) that indicate the main vascular problems of each of these regions. Detailed anatomical localizations of the main arteries in these topographic regions of the face and their relationships are described. Conclusions: The highest index of vascular lesions and especially visual alterations occurred for fillings of the upper third of the face. To prevent and avoid this type of lesion, it is advisable to avoid, as much as possible, treatments with filling materials in the upper third of the face, mainly including the glabellar and nasal region (III) and supraorbital region (VIII).

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“…5,6 Typically, an ipsilateral carotid bruit is present, aortic or cardiac disease are absent, and there are no exogenous sources of emboli, for example, intravenous drug use, severe trauma, or the injection of cosmetic facial fillers (such as autologous fat, collagen, or hyaluronic acid). 7 A cholesterol embolus is a poor prognostic sign: 93% of such patients have vascular disease at presentation, 15% die within the first year, and 55% in 7 years. The cause of death is heart disease, 6:1 over stroke.…”

Section: Clinical Signsmentioning

confidence: 99%