Can You Become Permanently Blind After Using Dermal Fillers?
Updated on January 21, 2022
Medically reviewed by William Truswell, MD
Facial injections can be done with dermal fillers or fat to fill laugh lines that run from the outer nostril to the corner of the mouth, or to fill the vertical frown lines in between the eyes. Cosmetic injections with dermal fillers, such as Juvéderm, Restylane, Perlane, Radiesse, Collagen, etc., and fat injections to the face are becoming more and more popular. While mostly safe, there is one devastating, but extremely rare complication to consider.
BLINDNESS MAY OCCUR
There are many small blood vessels, specifically arteries, in the forehead and eye area that supply blood to the area. Improper use of dermal fillers and fat injections can lead to the blockage of a blood vessel that supplies blood to the eye.1 When the blood is prevented from reaching the eye because of the blockage, blindness is the result. This condition is known as retinal artery occlusion (RAO).
According to a study published in the American Journal of Ophthalmology, 12 patients experienced a sudden loss of vision following cosmetic injections to the face, and the prognosis was worse after injections with fat. This was thought to be due to the variation in the size of the fat globules, which can be small, medium or large. Variation in size leads to the blockage of small, medium and large-sized arteries. Dermal filler particles are smaller and more constant in size, and therefore will potentially block only certain smaller-sized arteries. Consequently, larger arteries will be spared. As a result, the blindness prognosis may not be as bad as the bigger blood vessels but are still able to deliver blood with oxygen and nutrients to the eye.
Since this initial study, other studies and reviews of the scientific literature have been done, and they come to the same conclusion: Blindness is a possible side effect of facial injections.
ARE COMPLICATIONS COMMON?
The demand is high for this type of procedure, and people are getting these types of injections done at younger and younger ages. As the age at which people start getting these injections continues to decrease, it's even more crucial that both the short-term and long-term potential complications are fully understood before undertaking such procedures.
Having fat or dermal fillers injected into the facial area is usually quite innocuous. Normal occurrences after injections of a dermal filler include temporary redness at the site of injection, and perhaps some temporary soreness and swelling. These symptoms are also normal after having fat injected into the face. The swelling after a fat injection persists longer than the swelling associated with dermal fillers and is usually more pronounced. Nodules or lumps under the skin can occur after either dermal filler injections or fat injections.
Serious complications after cosmetic facial injections are quite rare, but when they do happen, they are quite devastating. Many people who have facial enhancement with injections may be unaware of the potentially permanent complication that can occur with facial injections, namely blindness, although some partial vision recovery has been possible with hyaluronic acid and calcium hydroxylapatite fillers.
Considering the number of facial injections done, the occurrence of this problem is quite rare—researchers estimate an incidence of approximately 50 cases per year.
5 Sources:
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Xin L, Du L, Lu JJ. A novel hypothesis of visual loss secondary to cosmetic facial filler injection. Ann Plast Surg. 2015 Sep; 75(3): 258–260. doi:10.1097/SAP.0000000000000572.
Park SW, Woo SJ, Park KH, Huh JW, Jung C, Kwon OK. Iatrogenic retinal artery occlusion caused by cosmetic facial filler injections. American Journal of Ophthalmology. 2012 Oct 1;154(4):653-62. doi:10.1016/j.ajo.2012.04.019
Carruthers JD, Fagien S, Rohrich RJ, Weinkle S, Carruthers A. Blindness caused by cosmetic filler injection: a review of cause and therapy. Plast Reconstr Surg. 2014 Dec;134(6):1197-201. doi:10.1097/PRS.0000000000000754.
U.S. Food and Drug Administration. Dermal fillers (soft tissue fillers). Updated November 26, 2018.
Townshend A. Blindness after facial injection. J Clin Aesthet Dermatol. 2016;9(12):E5–E7.
Additional Reading
Bo L, Allen LH, Sheidow TG. Vision loss and vascular compromise with facial and periocular injections. Canadian J Ophthalmol. 2015; 50(4):e57-e60. doi: 10.1016/j.jcjo.2015.05.008.
Original article: https://www.verywellhealth.com/permanent-blindness-after-cosmetic-facial-injections-2710232