An Analysis of Severe Ophthalmologic Complications Following Plastic and Cosmetic Procedures: Insights and Experience Sharing.

Backgrounds: Although severe ocular complications following plastic and cosmetic surgeries or treatments are relatively uncommon, early diagnosis and intervention are essential for improving prognosis. This study investigates optimized strategies for the effective identification and management of these complications.

Methods: A retrospective study was conducted on 11 patients (10 female, 1male, mean age: 38.5) with severe ocular complications after plastic and aesthetic surgery or procedures treated at a single referral center between January 2014 and December 2024. Types of ocular complications and their etiologies, early diagnosis and management experiences were analyzed and summarized.

Results: 1 case of irreversible vision loss from ophthalmic artery occlusion after nasal augmentation with hyaluronic acid. 1 case of visual impairment from ophthalmic artery occlusion after autologous fat filler in the forehead. Delayed optic nerve injury with visual impairment after blepharoplasty in 2 cases. Unilateral vision loss after forehead fat accumulation correction in 1 case. Corneal damage causing visual impairment after upper eyelid ptosis surgery in 2 cases. Ocular micro-embolism and skin necrosis after hyaluronic acid filler in the forehead in 2 cases, without vision loss. Unilateral ptosis with reversible vision loss after hyaluronic acid filler in the forehead in 1 case, resolved with hyaluronidase. Corneal chemical burns and vision issues from iodophor entering the eye during eyelid blepharoplasty in 1 case, following treatment with epidermal growth factor, there was no significant improvement in vision. A flowchart for the prevention and management of severe ocular complications was developed and the risk factor for each case of severe complication was summarized.

Conclusion: Severe ocular complications from plastic and aesthetic surgeries are uncommon and need specialized knowledge for early detection and treatment to improve outcomes. Without this, they can cause irreversible damage or be life-threatening. Plastic and cosmetic surgeons must be well-versed in recognizing, evaluating, and treating rare but potentially serious ocular complications following surgeries or treatments.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .