Blindness from dermal fillers- how to reduce the risk and explain it to your clients.

Blindness from dermal fillers is a rare and serious complication. There are several ways you can reduce the risk and explain it to your clients.
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[@edamame-me]

I think filler injections to the face should be done with ultrasound guidance for safety and peace of mind.. In my opinion the Ultrasonography-guided Cannula Method for Hyaluronic Acid Filler would put a lot of worries to rest. And as a patient I would definitely opt for a doctor who has this equipment and uses this method. The technology exists so why aren’t all doctors using it? An ultrasound machine can’t be that expensive. I would pay extra for fillers to be safe and not risk my eyesight. Im sure others would agree.

[@nadineprice1753]

Cannula 22 gauge also. But always pull back on plunger for 5 seconds each time to make sure you give time for the blood to flow into the needle, if you see blood, not just a dot, you will know the difference. Then remove needle and re do in a different position.

[@sarapage8109]

Very interesting video and fillers are not to take likely. I suppose nothing is 100% safe and all procedures carry risk. I was thinking about having a non surgical nose job to hide my tiny bump but my husband is totally against. Thank you for sharing this video with us

[@skinappealclinic2046]

Excellent education as always Tim, thanks

[@PhienixxStJames]

Aren’t you not suppose to stick filler in the temples or frown lines anyways? Not even with a Hyaluron pen. I seen a video of someone putting filler in the corners of the nostrils. Like she did multiple shots! People should know this before messing with the face!

[@ranadobedny1937]

can you make a video clearly showing which vessels and areas on the face cause blindness and which are safe from this point of view?

[@nk9694]

Thank you so much for the information you provide !

[@miam5330]

Absolutely love your videos! Thank you!

[@nabilamorabet5868]

Hey doctor, what about using a machine that shows with a specific light the arteries? Thank you!

[@woundedhealer999]

I've been wanting to go for my first dermal filler for more than a year now. It's just too scary to think I could lose my sight, which is the most important thing to me. That is why I haven’t done it yet. I'm in my mid 30s.

[@izabelflood2837]

Thank you for sharing your knowledge.

[@jameslastimoso5404]

Its huge risk singer from ph is at risk of aneurysm, blindness, and stroke. Its done in the nose area. Doctors are human too even with knowledge and precautions there is a chance of doing it wrong. Now im afraid of doing it

[@littlemissgroove]

What???

[@emilykg]

This is great!!! Thanks!!!!!!!

[@drshirleykoeh]

Great video. love the way you described the measures. Do you normally inject filler into the canine fossa?

[@toffahahloua6781]

thank you for this helpful video.i would like to know if using a canula highly reduces the risk ?is it true that aspirations before injecting is not helpful since no blood comes out even if you are in a vaissel?thank you

[@heather-vs9qe]

Thank you for this video my gosh

[@rociovega4536]

Videos en español

[@mazdakmoradi5871]

Hi. thank you so much, doctor. what about the sides of the nose? I have a curve side and should be filled

[@johnlloydpacardo9397]

Is it possible when a filler is injected in the artery of the face and the solution could travel in the lungs resulting to embolism? Thank you so much for the answer.

[@BB-cy4ez]

Is it then safe to dissolve the filler in the bridge of the nose using Hyaluronidase?

[@Liliana-qi8rw]

So many unanswered questions....

[@lou8373]

If you bleed a lot during lip fillers for about 10 seconds does that mean you’ve hit a artery? And is blindness instantly when you’re there or later on?

[@littlemissgroove]

Instant

[@Angel-tv5lq]

In my view having carried out extensive research, it depends upon where about in the face you’re injecting. Ensure you know your 3D of facial anatomy as that helps so much, albeit in my personal opinion everyone is individual and therefore the absolute exact position of certain arteries may be ever so slightly different in each individual. In some cases you can feel the pulse where an artery lies, however those are the more superficial which is why a good 3D knowledge is essential.

[@lou8373]

Blythe Angel Psychic Medium thank you for replying😊

[@Boboelise]

Abraham Lincoln not true, blindness caused by dermal filler is instant. It blocks the blood supply to the retina

[@ocemo]

is there a way to make it 100% risk free? Like injecting very very slowly(taking like 1 min break between each push) or just inject small amount?

[@peachy7586]

I was wondering this too

[@fatimaalzahraa1313]

I am.waiting for the answer

[@Spacereform3]

What are some key points for nasal safety? Like I hear mixed opinions about cannulas for the nose - some studies claim this can increase risk in the nasal region. I get my nose done occasionally, but I inject on both sides to even out the indentations/crookedness. I know there are arteries on the sides too. What are some ways I can remain or be as safe as possible? (We likely only use 0.2 - 0.4 on the nose region). Also, for the nasal tip - where the septum is, would filling that crease/line in the centre be considerably dangerous too? Keen to hear some responses 😊 Thank you!

[@sunnydae777]

Doctor. Is juvedermvoluma easy to aspirate with 27g needle. Thanks

[@nikolajnielsen1466]

Should I be afraid?got deep dark circles is there other ways to get rid of them than fillers im already very nearsigthted it makes me very afraid to hear this...........

[@edenposh1890]

you are talking about cross linked HA...right? is non-cross linked presenting the same problem??

[@edenposh1890]

www.realself.com/question/los-angeles-ca-cross-linked-hyaluronic-acid-products-vascular-occlusion

[@bob6168able]

Wish that someone tell me what is meant by aspirate ?

[@user-vc9gg6es7k]

How can i know the risk aera in lip when i injection filler ?!

[@joyceroundy9402]

what about the under eye tear era is that a risk i keep hearing about the nose part and forhead thank yuo

[@marybeltran4612]

Is thier a risk of blindness if u get it on the nosefolds

[@ems8717]

yes even more!

[@TheKuldi]

What about botox injections and the veins in the forehead? What happens if you get an injection into the bloodstream??

[@Skinvivatraining]

Great question- Nothing measurable happens with botox in the blood, there's simply too little to have an effect once it gets mixed with other fluids in the system.

[@georgiadaly5445]

Is lip filler safe?

[@WyclifLuyima]

Thanks for the info, I know someone considering doing one of these fillers and they were looking up risks and came across this, these are my thoughts on the issue based on simple science and logic about the worst complications (blindness and brain damage). 1- I would think these complications should only arise when procedures are done by a non trained/certified person like in a beauty shop, is there any evidence where these adverse complications happened with a trained professional in a legit health center? 2- Yes the nose is close to eyes and brain but the arteries that get to it are small given they are at the end of the branches of the blood vessel tree. 3- Still on the nose, the arteries to the nose comes in from the top of the bridge and move down the bridge while getting smaller meaning the true higher risk area would be top part of the bridge and not lower, right? 4- Given that in some areas like the nose bridge you actually find artery endings and blood is flowing in smaller arteries away from the main arteries that go to the brain and eyes, it means for the filler to go against the direction of the blood flow, it must have been applied with fairly very high pressure to move all the way backwards and get to the main artery that also supplies the eyes and brain which could just mean either the surgeon has a motive to harm you or it's a really non trained person applying to much pressure to the syringe because they don't understand what they are doing, or you have really low blood pressure. 5- The blood vessel system is double sided (left and right), meaning you should technically get blind in one eye and never both both unless the person applying it is going too fast and makes 2 quick injections on both sides of the artery tree to end up effecting both eyes which again leaves me thinking they had a motive to harm you. To eliminate chances of these complications, I would think this is what you need to do: 1- First take one's blood pressure to make sure it's not low. 2- Isn't it possible to first apply the dissolving substance in retinal artery and artery that continues to the brain before injecting filler as a safe guard to block any chance of passage of the filler on it's way to the eyes and brain? 3- This being 2020, is there really no device that can show you blood vessels under the skin as you apply the filler? So you can avoid them, something along the lines of accuvein 4- Why can't they use an electronic syringe to push the filler after the surgeon makes the piercing because that way you would set it to a precise pressure to exert based on one's blood pressure. 5- Why not first make a test to locate the nearby arteries and their depth around the point of injection to avoid them and not go too deep enough to get to the skin layers with arteries? In summary, I would imagine that these adverse complications should really never occur in case of a trained certified professional with no bad motive and the patient is healthy with no low blood pressure, correct?

[@paulmatei9049]

I would like to know the answer to these questions too, especially the device one, there must be something.

[@badkittymichigan7029]

Hello I am being trained in Hyaluron pen which isn’t suppose to go pass the dermis no needles I feel like this is safer but what do you think?

[@dandan9175]

Questions coming through!!!What techniques do you use when injecting fillers? Is it better inserting the needle only in one spot and spread the filler under the skin evenly across the tear lines, or you inject in 3 different spot? I've seen different techniques and was wondering which of them is more efficient. Also, how much injection do you put at a time?TY :)

[@q1b21]

what do you mean by "aspirate" for every .5 mils?

[@tsputube99]

aspirate, if clear, then inject, but no more than 0.5. if i'm using a straight needle i don't go past 0.05. if cannula, which is daily now on almost everyone, i'll go up to 0.2 in one spot, then move or drag to ew region. but if you change location even by a couple mm's do the same. aspirate 1st. you don't put in more than .5 because of compression.. I've seen injectors go deep into the nasolabial folds and just dump almost the entire 1cc syringe just in that region with the angular right there. no aspiration. just wham. awful and dangerous technique.

[@SouRGraphics]

tsputube99 how would I inject in the chin for more projection?

[@manscape8810]

Thank you for sharing this important info. We did a video clip about enhancing Mens cheeks and chin with fillers, done by Dr. Charles Randquist in Stockholm, Sweden and he talked about the risks with filler injections as well. Check it out! Have a nice weekend.

[@georgiadaly5445]

Are lip fillers moresafe??

[@lotusflower7556]

I heard that the filler can migrate and cause a stroke .

[@heather-vs9qe]

Yes l have heard that as well

[@redlady935]

@@heather-vs9qe 😬

[@af-pqueen4287]

where are you based in the UK? i would rather get it done by you than anyone else

[@skinnybuddhaboy]

Thanks for your video, this is very important information for people to know. I was wondering, would getting fillers in the mandibular angle jaw region (beneath where the jaw muscle is and where the angle of the jaw bone is) of the face carry any risk?

[@SouRGraphics]

SKINNY BUDDHA BOY what did you find out?

[@DrLetiziaMansutti]

Thanks for the video. How many cases have been described by now? What is the best workup and management in case of acute blindness? May the ophthalmologist be of help? Is retrobulbar hyaluronidase the best solution?

[@Skinvivatraining]

Retrobulbar hyaluronidase or attempting to cannulate the supratrochlear artery at the notch have both been utilised. I would also directly flood the area injected. We actually discuss in our podcast here: soundcloud.com/user-393280270/aesthetics-mastery-ep1-blindness

[@tsputube99]

track is not found??? can you please repost with an updated link?? thanks

[@raghadeid89]

How long does it take for blindness to happen ?

[@Dylan-ni9my]

Almost always immediately, one case reported showing 3 weeks, only ever case reported

[@Nyc520]

I hear that the chin and jawline area are very low risk for blindness because of the lack of arteries there, is this true?

[@SouRGraphics]

M Z what did you find out? I’m interested in this too

[@cocochocs3126]

I’ve had my chin done and all ok so far I have an awfully small receding chin so has to do something about it

[@dontreadmyprofilepicture4689]

So can i get lip injections even if just a little or kinda a little bc i really don't know if i should get them or not, do you think if i get lip injections i would go blind?

[@brendacastillo8146]

What happens if I already had nose filler and everything went o.k,I still can experience blindness within the next months ?

[@Dylan-ni9my]

No

[@jasimkerim6773]

it rarely happen. ..nose filler is better than surgical nose correction. ..

[@Skinvivatraining]

There is risk and reward in all things- getting run over is rare, but we all believe it's worth crossing the street. It depends on how much a persons nose affects them.

[@havepeaceonearth]

I had nose surgery two decades ago. I went in not knowing the risks..I was young and all I thought about was anesthesia risk... everything went ok. But nowadays I was thinking of fillers but since their is a risk, I am not doing it. I will learn pro makeup techniques if I ever want to change something. Crossing the street is required but getting fillers is not. No anxiety over filler risk, even if small, for me.

[@latabarlatabar4633]

Is this blindness permanent?

[@Dylan-ni9my]

Yes

[@AttilaTheHunky]

Thank you very much dr. It was very explicit I have a situation where I was injected in the frown area between the eyes some silicone microdroplets 1000 so I wont have any frowns..... I haven't had any side effects fr it and it's been already five years that I have in ..... all I noticed is that the collagen have grown and I have been recommended by a doctor to have use Kellogg to reduce the size and it has helped somewhat.... wondering once it has bin inserted will I have any consequences later on in my life ? should I have it removed or should I just leave it there so far I'm not having any issues or any problems with it and also I have some silicone 1000 microdroplets inserted in my cheeks because of roller acne scars and it is now all gone.... thank God everything is fine so far but I'm worried because a lot of doctors have been telling once you have the silicone 1000 implanted in your skin you will develop blindness throughout your life I am scared to death now is that true? Next I have recently done a dermabrasion on my nose which left a little indentation on the corner and I'm considering some Sculptra or maybe some suture to remove the it ......do you think the nose is okay to fill a small indentation?

[@joywisdom6598]

Zoltan Attila Elekman Just give up doing so much to yourself , one thing leads to another problem. It seems decades after new cosmetic procedures , there are always problems. Believe me I wish it wasn't true ! These things just aren't natural. After working for many Drs. it seems , many studies just aren't long term & what's said to be safe today may not be tommorrow.

[@q1b21]

blind yet?

[@AnitaN844]

Why ur videos put me off?shouldn't be like that :(

[@cuzu5145]

Risk blindness are you crazy the reward is not worth risk

[@monikaengel5515]

How about lip injections can also cause blindness from judeverm?

[@karenfrench9741]

Can Botox cause blindness as I'm supposed to be having it done soon and I'm bit worried

[@monikaengel5515]

@@karenfrench9741 can cause facial paralysis and is very toxic .I'm 40 and happy to be natural not fake ,eat healthy, workout and stress free.Botox is short period time always risky and get muscle by time faster aging so my opinion I'm accept age and appreciate to be healthy.

[@cocochocs3126]

Monika Engel lip fillers any filler in face can cause blindness

[@Sarahahaha551]

If hyaluronic acid is used, the chance of going blind is not really there right? Cause it can be dissolved. Or is there a chance the dissolving stuff wont work?

[@ginagherase7689]

It can be didissolved if it's in subcutaneous, but if it goes to a vessel it will migrate in the vessels.

[@dthompson5234]

Regardless of what type the filler is, if the filler enters an artery it can stop blood flow to the eyes which is what can cause the blindness/nacrosis. However it's very rare though, and most of the cases are coming from practioners who are not trained in the anatomy

[@littlemissgroove]

@@dthompson5234 Do you know where I can get this info please?

[@lillydog12]

Does using a micro canula reduce or even eliminate the risk?

[@TimPearce1]

You really struggle doing this superficially, they tend to want to be deeper. There have been several cases in South Korea of blindness using canula in NS rhinoplasty- possibly due to the tight space and false security.

[@tere1198]

Is it permanent?

[@redlady935]

Yes. Only 2 cases did they manage to reverse it.

[@havepeaceonearth]

Then I will never ever put myself through the anxiety of hoping that I am not the rare case that something goes wrong...so no fillers for me.

[@sarapage8109]

Is the blind ness permanent by the way?

[@TheJam154]

Yes it is but risk is very low but still consider this as potential risk

[@EmilyJensenNutrition]

Would it be possible to go blind from lip filler?

[@needlovex]

Emily Jensen Nutrition yes there’s a risk

[@Skinvivatraining]

It's possible, but vastly less likely than other areas. 1 in many millions chance.

[@joywisdom6598]

yes

[@cocochocs3126]

Derealization No More he said yes one of the riskiest places

[@karenfrench9741]

@@Skinvivatraining can Botox cause blindness

[@heather-vs9qe]

My dazz