Question: I hear the FDA recently issued a bulletin warning that fillers can be dangerous. What are the risks and what should I do?
Answer:
This is what the FDA has said and what Dr. Morgan suggests as well.
The FDA alert dealt with the risk of fillers being injected unintentionally into blood vessels in the face. The forehead and eyes are especially risky. The alert is based on research by plastic surgeons showing that fillers injected into facial arteries and veins can damage skin and other tissues, including the eye and brain. This is very rare, but obviously very serious.
The FDA suggestions are that you, the patient, should:
1. Talk to the health care provider before you are treated
2. Ask about the provider’s filler training and experience
3. Read the filler labelling
4. Visit fda.gov for information on approved fillers
5. Seek immediate attention if you have a complication.
Physicians should:
1. Be trained and have experience giving fillers
2. Know the anatomy, including blood vessels, of the face
3. Inform you of the risks of having fillers
4. Inject with care
5. Know the signs of filler injection into a blood vessel
6. Stop injecting if this is happening
7. Get you medical care if this happens
8. Train the staff to help patients with such complications
These guidelines, in Dr. Morgan’s opinion, have two problems.
First it does not mention specific steps that make filler injections safer: injecting local anesthetic to shrink blood vessels, using cannulas instead of needles when possible, testing before injecting, having Vitrase (filler dissolving enzyme) available to dissolve a dissolvable fillers.
Second, the FDA guidelines are only for physicians. What about the many non-physicians, including nurses, NPs, Pas, dentists and chiropractors in offices, spas and clinics who routinely inject fillers, often with little training. Although many are in clinics with a medical director, that physician may have no filler experience and may not be on-site.
Dr. Morgan personally feels that fillers are best injected by physicians specializing in cosmetic treatments, however if you have someone else inject your filler, always be sure that there is a physician experienced in cosmetic treatments immediately available in case a problem arises.