Adverse events seen with fillers

Abstract

Dermal fillers are often utilized to enhance facial features as well as correct signs of aging on the face. Common side effects seen with dermal fillers are injection site erythema, edema, and secondary infection. Uncommon yet severe effects of filler injection result from vascular occlusion, causing skin necrosis, blindness, or even stroke. Vision loss typically occurs immediately after injection. Partial vision loss is associated with better prognosis. In case of visual compromise, an ocular massage and reduction of ocular pressure should be initiated immediately. The instruments used as well as the pressure and volume of the injection can contribute to unwanted complications. Anti-thrombolytics, including hyaluronidase for hyaluronic acid injection, may offer some benefit in the case of vascular occlusion. Aesthetic providers must have thorough knowledge of facial anatomy and proper injection technique to mitigate the risk of these dreaded adverse events.