Cosmetic Facial Filler Injections Can Cause Severe Vision Loss, Studies Find

March 2014 — Injections of facial fillers to remove wrinkles between the eyebrows and from other areas of the face can cause severe visual side effects in some cases, according to two recent studies.

In both studies, researchers in South Korea evaluated vision problems occurring after these cosmetic procedures.

Facial filler injections often are used to remove wrinkles from the glabella (area between the eyebrows) and/or the nasolabial folds (skin folds on each side of the nose that separate the cheeks from the upper lip — where “smile lines” or “laugh lines” occur).

Both studies revealed that use of cosmetic facial filler injections can sometimes cause painful blindness due to blockage of arteries that nourish the retina (for example, central retinal artery occlusion or branch retinal artery occlusion; sometimes called “eye occlusions”). In some cases, retinal artery occlusion following these injections can be accompanied by brain infarction (stroke).

Patients injected with autologous fat (fat obtained from a different location on the same person’s body) had worse visual outcomes and greater risk of stroke than those who were injected with hyaluronic acid or collagen. (Hyaluronic acid is a viscous fluid naturally present in the human body, particularly in the eyes and joints. Collagen is protein found in connective tissue throughout the body, including in the cornea.)

The study authors concluded that cosmetic filler injections between the eyebrows and for “smile lines” can sometimes cause painful blindness or even stroke, especially when autologous fat is used.

People who experience eye pain after cosmetic facial filler injections should undergo a dilated eye exam and brain magnetic resonance imaging (MRI), they said.

They added that caution should be used during cosmetic facial filler injections, and physicians should be aware of various possible complications afterward. — G.H.