What are some risks of wrinkle filler injections?

Arthur W. Perry, MD
Plastic Surgery
While wildly popular, wrinkle filler injections are not without risk. Collagen injections have a high chance of causing allergic reactions. Skin tests are required prior to injection. Repeated collagen injections may lead to the development of diseases similar to rheumatoid arthritis. Allergan recommends that no more than an ounce be injected per year. Allergic reactions are much less likely with the newer fillers.

More important, the semisolid wrinkle fillers can be accidentally injected into blood vessels. When this happens, disaster looms. Around the eyes, nose, forehead, nasolabial folds, and even the lips, blood vessels link the skin with the eyeball and even the brain. If filler gets in these blood vessels, the result is immediate and permanent blindness. At least forty-three cases of blindness have been reported from injections around the eyes. If the material floats into the brain, a stroke can result. In other areas of the face, the consequences are not as severe, but loss of skin can result. The most common area of skin loss is between the eyebrows: the material mechanically blocks the blood vessels, resulting in the death of tissue in the affected area. Liquids such as Botox cannot occlude the blood vessels and therefore will not result in this problem.

Surgeons take special precautions to avoid injecting into blood vessels. Ice and anesthetics with epinephrine shrink the blood vessels, and the doctor injects only while withdrawing the needle. Some physicians make a tiny stab in the skin and use a blunt needle to place the filler, further limiting the chance of injecting into a vessel. The fillers are injected using minimal force. Many doctors simply will not take the risk and will not inject around the eyes. As more injections are performed by less-trained people, disasters will be more common.

Any injectable material can activate herpes infections. Patients who have herpes sores should receive an antiviral before and after the injection. And injections should not be performed during an acne breakout. When fillers are injected, they eventually break down and are absorbed by the body. No one knows what happens if they are exposed to different types of lasers or radiofrequency energy. We may be in for some surprises. Until we know better, I recommend not lasering areas that have been filled. Laser first, then fill.
Straight Talk about Cosmetic Surgery (Yale University Press Health & Wellness)

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Straight Talk about Cosmetic Surgery (Yale University Press Health & Wellness)

The public’s recent exuberance toward cosmetic surgery has spurred an unprecedented demand for appearance-changing procedures. But how can an average consumer discern the hype from solid truth? ...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.