Question: I hear the FDA recently issued a bulletin warning that fillers can be dangerous in some parts of the face. Is this true? Can the risk be reduced?
Answer:
Yes it is true. And yes, your risks can be reduced.
This is not news for any plastic surgeon. The FDA warning follows new studies done by plastic surgeons on the risks of fillers.
Here is the issue – the forehead, between the brows and around the eyes can form deep lines, but there are important blood vessels underneath these wrinkles. So filler can end up being injected into these blood vessels. This plugs up the blood vessel. Since these blood vessels are near the eye and the brain, blindness and stroke can occur. This is very, very rare, but it is important to understand it can occur.
It does not occur with Botox because it is a liquid that does not block blood vessels. It is safely injected in these areas.
Does this mean filler should never be injected in the forehead? No – Dr. Morgan will occasionally do such injections, but only with important precautions.
Many health practitioners doing filler injections – nurses, PAs, dentists and podiatrists – don’t have the training or experience of a plastic surgeon. They often do injections in these areas, not understanding the risks. What seems safe to them may in fact not be safe.
Here is what to do if you want the safest possible facial filler injection in risky areas:
- Have a plastic surgeon do the injection.
- S/he will first inject local anesthesia with epinephrine to shrink the blood vessels.
- A cannula, not a needle, is used. Cannulas are designed to avoid injection into blood vessels.
- Vitrase – a filler-dissolving enzyme – should be immediately available.
With these precautions, injections in these areas is still more risky than elsewhere, but can be done with the lowest possible risk if filler in this area is important to you.
Watch in this video as Dr. Morgan explains all you need to know about fillers: