Here Are The Actual Risks Of Getting Under-Eye Fillers

If you are interested in skincare, you have probably heard of the latest dermatological frenzy: Injectable fillers (often known simply as “fillers”). The minimally invasive cosmetic procedure — which consists of injecting materials like Hyaluronic acid (sold under the brand names Restylane®, Hydrafill®, Hylaform® and Juvederm®) or collagen into the skin — is meant to reconstruct facial deformities (think: reshaping your nose) and reverse signs of aging (think: plumping up your lips).

Fillers have been around since the 1970s, however, they have become increasingly in popular in recent years. In the United States alone, the use of fillers climbed from 1.8 million procedures in 2010 to 3.8 million in 2019, according to research from the American Society of Plastic Surgeons. Even during quarantine in 2020, at least 3.4 million people got some sort of injectable touch-up. 

However, as with all cosmetic treatments, complications and adverse events can occur. One of the most popular areas for filler, the under-eyes (also known as the tear-trough) does carry a risk for side effects, but just how bad is it, really? 

Complications are rare, but the risk remains

One of the reasons injectables have become so popular are because of their “non-invasive” nature. When performed correctly, FDA-approved fillers cause minimal disruption to tissue. Still, there have been documented cases of devastating complications, the most serious being comprising vascular occlusions, which can lead to “necrosis (tissue death), scarring and, even more seriously, blindness,” according to the Harley Academy. Hyaluronic acid is the most frequently used soft tissue filler in practice and the second most common (after autologous fat injections) associated with ocular complications. 

One study in 2015 reported 98 cases of blindness from soft tissue facial fillers. Out of those cases, 65 led to unilateral vision loss, and only two of the cases were reversible. The blindness is caused by a condition called retinal artery occlusion (RAO), which is when a blood clot or blockage of an artery prevents blood from reaching the eye. The under-eye and forehead areas, in particular, are filled with many blood vessels that make them more susceptible to RAO from improper filler use, according to Millicent Odunze Geers, MD, MPH. In general, though, complications from injectables are quite rare, with researchers estimating that only 50 cases occur a year. 

Other less serious, common side effects include swelling, bruising, redness, and temporary pain. 

How to lower your risk of potential complications

While the aforementioned adverse events are rare, they are still very serious. On that note, there are ways one can lower their risk of side effects. For starters, always (and we mean ALWAYS) make sure you are going to a board-certified dermatologist, plastic surgeon, or ENT surgeon who has a comprehensive, working knowledge of vascular anatomy. This ensures that your doctor knows exactly what tissue plane to inject to avoid any problems, especially since the tear-trough area is delicate and generally a tight space. 

Second, NEVER buy injectables online and try to do this yourself (you may be thinking “Duh!” but you would be surprised at how many people try to self-inject fillers). Lastly, accept if your facial or eyelid anatomy is simply not right for this procedure (an accredited MD will be able to tell you this). Trust your doctor on this one and don’t try to go to a non-certified med-spa because you just have to get this procedure.  

As always, you are all perfect the way you are, but if you want to get some tweaking (and there’s nothing wrong with that), please, do your research!

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