Filler Danger Zones: What to Know?
Certain regions of the face are at a higher risk for complications due to underlying anatomy. When approaching a filler patient, an injector must be well-versed in anatomy. Knowledge of underlying facial vessels and nerve bundles that supply critical areas of the face is essential.
The most severe complication associated with fillers is a vascular occlusion. When filler is injected into or near a blood vessel causing compression, it occludes or blocks blood flow resulting in decreased/diminished oxygen to the area. If not treated, this can result in skin ulcers, scarring, necrosis, and/or vision loss.
While this risk is rare, complications associated with dermal fillers arise in most cases from injector experience or the use of unapproved products. Your injector should be experienced and skilled when injecting fillers and caution must be taken to avoid injecting near vessels or nerves.
These areas of the face we consider “danger zones”:
Temple: Superficial Temporal Artery and Deep Temporal Arteries
Glabella, Forehead: Supratrochlear Artery, Supraorbital Artery
Tear Trough: Infraorbital Artery
Nose: Dorsal Nasal Artery, Lateral Nasal Artery, External Nasal Arteries
Lips/Perioral Area: Superior Labial Artery, Inferior Labial Artery
Nasolabial Fold: Infraorbital Foramen, Dorsal Nasal Artery, Angular Artery
Chin, Jawline: Mental Artery and Foramen, Facial Artery
When choosing these areas to inject, make sure that your provider is experienced in treating high-risk areas and knows how to manage complications.
Signs of Vascular Occlusion:
Skin blanching (whitish) skin
Dusky (grayish blue) skin
Expanding Bruises and/or Blotching Redness
Intense Pain
What To Do: if you notice any of the above signs, please contact your injector immediately!
Warm Compress, Do NOT apply ice
Massage area
Aspirin 80mg
Hyaluronidase (dissolve) in office