I will be having Restylane injected for my under eye hollows. I am so afraid. I worry about retinal occulusion, and blindness. I also worry about long term effects. Can you give me your opinion about the procedure under the eyes? Thank you.
Can Restylane Injections Damage my Eyes?
Doctor Answers (21)
Don't have Restylane injection for under eye hollows
Although many doctors use Restylane, Juvederm and other soft tissue fillers to correct under eye hollows, I do not.
Although retinal artery occlusion and blindness is very rare and unlikely (2 cases in the literature), visible lumps under the skin and downward migration of the filler is very common.
The eyelid skin is so thin that the filler is often visible as grey lumps.
More commonly, filler injections for under eye hollows, after 6 months are pushed downward by gravity and the action of the eyelid muscle, and the rim of filler is seen on the rim of the orbital bone beneath the dark eye hollow-this actually makes the hollow look worse.
Many, many doctors disagree with me, but i have seen these prob;lems in patients who have had their filler injections iunde rthe eye done by the 'worlds experts' at filler injection.
If you want to do this be certain you see a widely recognized expert board certified plastic surgeon and have him/her show you before and long term 96 months or longer0 results of his/her patients that they have injected.
In my opinion, the proper procedure to correct under eye hollows is surgical fat grafting--it is permanent and smooth-see reference below.
Blindness from Restylane is highly unlikely
Restylane injections are very safe when performed by someone who has alot of experience working around the eyes, such as an oculoplastic surgeon. It's true that if the material is injected into a blood vessel, this can cause retinal artery occlusion and blindness. I have seen one case described in the medical literature. I always withdraw the needle as I'm injecting so as not to push filler into a vessel. Again, make sure you go to someone experience with injections of Restylane around the eyes and you'll be just fine.
RESTYLANE AND THE EYE
Restylane and other hyaluronic acid derivatives are an effective and time proven substance for correcting under eye hollowing (tear troughs). The usual side effects are bruising, redness, and tenderness that subside quickly. Lumpiness or a blue-tinge to the eyelid skin (Tyndall effect) are other side effects resulting from misplacement of the filler substance.
In extremely rare instances the injectable filler can be inadvertently placed into a vein or artery resulting in a stroke to the retina or optic nerve and permanent blindness. Once again this is an exceedingly rare side effect of treatment.
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I really love doing hyaluronic treatments under the eyes. I say this even though I am a facial plastic surgeon who does eyelid surgery every week! I started doing the injections about 4 years ago and have even had the treatment myself about 2 years ago. It is amazing as the results can easily last 2-3 years( if not longer). Although reports of blindness are present in the literature I would recommend that you choose your doctor carefully and consider the background, training and experience to lower the risk of any possible untoward outcomes.
Robert. Gray, MD, FACS
Can Restylane Injections Damage my Eye
There have been reports of blindness from injection of dermal fillers around the eyes in very rare cases . That is why it is important to see a board certified Plastic Surgeon who has experience with these injections.
As they say “anything can happen”, although it seems an unfortunate expression for your question. My answer is that there will always be risks but if you have a qualified doctor who is aware of not only the anatomy of the face but the eye as well, your risk of damage will decrease. It comes down to who you choose to have your procedure done. My advice, choose wisely!
Restylane under the eyes must be done carefully.
You asked if there was a risk of damage to your vision. I must say yes, there are more risks associated with under eye filler injection than with the more straightforward nasolabial (melolabial) fold injections. 100% for sure only a board certified dermatologist or plastic surgeon experienced in surgical procedures around the eye should be performing this procedure. Many think they can do it, but many run into trouble, ranging from visible filler lumps that never go away, to occlusion of a blood vessel in the area. Be very cautious when selecting your physician.
Restylane injections for under eye hollows.
Blindness rare complication of fillers around eyes
Retinal artery occlusion is also a very small risk when having fillers injected into the forehead and nasolabial folds (where cheeks meet the nose and upper lip). In order to avoid this complication, experienced injectors use very small needles, apply ice to the skin prior to injection (to constrict the vessels), inject very slowly, and pull the needle out of the skin while injecting.
If you have more loose skin under the eyes, a lower blepharoplasty may be a better option.
Please consult with an experienced board certified dermatologist or plastic surgeon.
Restylane under eyes
I find that Restylane injections under the eyes are a great treatment for under eye hollows and can sometimes be used to camoflage puffiness under the eyes in patients who are not ready for surgery. I have treated hundreds of patients with under eye injections (including myself) and have never had any of the problems you mentioned in your question. No cosmetic procedure or treatment is without risk, but Restylane injections under the eyes have an excellent track record overall. Definitely seek out a doctor who has a lot of experience with this specific treatment.
The biggest downside to under eye injections is bruising, which can sometimes be severe and can last two weeks (or more). That being said, I find the vast majority of patients are extremely happy with the procedure and recommend it to their friends and family.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.