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Dermal Fillers
What does a “high risk area” entail and what can happen?
One of the inherent risks of filler is something called "vascular occlusion." This occurs when filler is inadvertently injected into a vessel and can block blood flow, resulting in ischemia (oxygen deprivation) and possible tissue death, scarring or blindness. Certain areas are considered "high risk" because there is an increase risk for occlusion due to the circulation pattern in that region and the increased chance of connecting with the central retinal artery which is responsible for partial or complete blindness. If occlusion of this vessel occurs, there is low possibility for reversal even with hyaluronidase. I can understand why some injectors would choose to minimize their liability and risk by not offering this treatment area. It's up to the patient to choose an experienced, qualified provider that they both feel comfortable with the procedure, risks and benefits.
Clinical Context
High-risk areas like the glabella, nasal sidewall, and tear trough have blood vessels that connect closely to the eye's blood supply, with little tissue cushioning to protect against misplaced injections. This anatomy makes vascular occlusion more likely and more dangerous if it happens near the eye. Experienced injectors use careful technique to lower this risk, but no method removes it completely. Choosing a provider skilled in facial anatomy and prepared to manage complications is essential when treating these areas.
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