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Restylane Perlane In the Glabella Area. The Injection Area Is Now White And I Have Dizziness. What Should I Do?

asked 10 months ago by aedberg in UK
Latest answer by Jessica J. Krant, MD, MPH
Question viewed 502 times
Tags: 1 day post-op, dizzy, white

I had a treatment with Restylane Perlane 24 h ago in the glabella area. I didnt have a deep wrinkle in the middle so it was injected next to the end of each eyebrow.It was also injected below the glabella in the upper part of the nose bridge. I felt that it came in to a blood vessle or artery. The area turned white,I felt dizzy,got a high pulse and my blood pressure increased. The area in my forehead is still white and the area is shaped like a Y turned upside down. If I touch it I feel dizzy.

15 answers to Restylane Perlane In the Glabella Area. The Injection Area Is Now White And I Have Dizziness. What Should I Do?

+3

Blood Flow occlusion after Filler in Glabellla Area

What you are describing is the possible occlusion of blood flow in the area as a result of fillers injected into this area. Although not common this is a known risk of fillers in this area. Please get evaluated ASAP because if so hyaluronidase injected into the area can dissolve the filler preventing the necrosis (death) of tissue in this area.
Ted Brezel, MD

Long Island Dermatologist
+2

Restylane can be used in the glabella for wrinkles between the brows

However, it must be done by a skilled experienced injector. If too much (or too thick of product, in the case of Perlane) is put in the area, it can cause a compression syndrome that can affect the blood vessels above the medial part of the brow, leading to whiteness or blanching. If that were to occur in the doctors office, immediate treatment with nitropaste and hyaluronidase is key to relieve the pressure. If it happened later you should see your doctor immediately for... more
Carolyn Jacob, MD

Chicago Dermatologic Surgeon
+2

Restylane and perlane injected into glabella, now with white discoloration what should I do?

Fillers, IMHO, should not be injected into the glabella especially in the area adjacent to the head of the eyebrows. Contained in this area is an artery, thin walled vein and nerve. The filler can obstruct and pinch off the thin walled vein creating a quarter sized area of dead tissue and scar, in the middle of the forehead. This complication is well known and described in the medical literature from the early days of collagen injections. I know that many... more
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+2

Have your doctor check this out.

Rarely Restylane or any other filler can occlude an artery in the glabellar area and shut off the blood supply to a small area of skin. You should immediately check back with your doctor who did the treatment to assess what is going on.
Mark Taylor, MD

Salt Lake City Dermatologic Surgeon
+2

This is actually a dangerous place for filler.

There are a couple of possibilities here. One is that the blanching is causing you to feel panic. Another possiblity is that this filler was embolized into your cerebral circulation and you are actually experiencing a type of stroke syndrome. Hyaluronidase could help in either situation. Early recognition and care are essential. Local effects can be helped with an immediate injection of hyaluronidase. Vascular disturbance in the brain circulation... more
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon
+2

Filler in glabella

If the area turned white, it may be causing compression to the vasculature or could have been injected into the artery. Hyaluronidaase may help or even nitro past. But, i would see my doctor ASAP.
Steven Wallach, MD

Manhattan Plastic Surgeon
+2

Restylane Perlane In the Glabella Area. The Injection Area Is Now White And I Have Dizziness. What Should I Do?

If you are having post injection issues ALWAYS best to return to the injecting doctor or at worst go to emergency care.
Darryl J. Blinski, MD

Miami Plastic Surgeon
+2

Perlane in the glabella, the area is now white and I have dizziness

It is not clear if the white color occurred immediately, while you were still in the Doctor's Office. If so, most likely he/she would have injected Hyaluronidase and applied Nitropaste immediately. If he/she didn't, or if the symptoms occurred after you left him/her, immediately call the Doctor who tinjected you, or a Board Certified Dermatologist or Plastic Surgeon to have these procedures done. Or, go to a big Hospital Emergency room. They... more
Eugene Mandrea, MD

Chicago Dermatologist

www.lakeviewderm.com

+2

White or dusky area in glabella after Restylane needs to be treated immediately

If there was compression of an artery or if some hyaluronic acid was inadvertantly injected into an artery, the sooner it is dissolved with hyaluronidase, the less tissue will be damaged. Please see your injecting doctor immediately.
Emily Altman, MD

Short Hills Dermatologic Surgeon

www.advancedskinwisdom.com

+2

Restylane in glabella

The single most important thing to do is reach your doctor immediately for an evaluation. In the case of blockage or constriction of a vessel it may help to apply warm compresses to increase blood flow to the area and take aspirin if no contraindications. The doctor may inject hyaluronidase to dissolve the restylane/ perlane if needed, but if it is needed, the sooner it's done, the better chances of benefitting from the treatment.
Doris Day, MD

New York Dermatologic Surgeon
+2

Risks of Injecting Fillers in the Glabellar Area

Filler injections in the glabellar area are quite safe as long as they are done superficially. This means the injections have to be done into the skin, not below it. Otherwise there is a risk of blocking the blood flow in a larger blood vessel which can become an urgent situation. You should immediately contact your injecting physician or go to an emergency room if your physician is unavailable. Warm compresses can be applied to the area immediately. The injection site should be treated with... more
Mitchell Schwartz, MD

South Burlington Dermatologic Surgeon

dorsetstreetdermatology.com

+2

Sounds like you need hyaluronidase injection ASAP

Sounds like the vessels in area are either plugged with ["embolized by"] Restylane Perlane®, or compressed by the Restylane Perlane®. The increased blood pressure and dizzyness is likely related to discomfort and anxiety, and not likely related to flow of the Restylane Perlane® back into your brain [circle of Willis] -- if that had happened you'd probably be dead. If you can't get hold of someone who can take care of you today, you could go to the ER of a... more
Kevin C. Smith, MD

Niagara Falls Dermatologic Surgeon
+2

Restylane/ Perlane in the glabella

I would recommend you call your physician right away. It does sound as if you have compromised blood flow to the skin in the area, either from a compressed blood vessel or product within the blood vessel. They physician can treat the area with hyaluronidase to restore some blood flow. I also recommend warm compresses to increase blood flow around the area. Your doctor may also prescribe a medication called nitropaste fir the area. Even though it is the weekend, you should be able to call... more
Jacqueline Calkin, MD

Sacramento Dermatologic Surgeon
+1

The danger of Restylane, Perlane, or Juvederm injected between brows.

Feeling a pressure between your eyebrows and noticing a white (or blueish/purplish) patch of skin above the area of injection can mean pressure on, or injection direclty into, a very important artery in that area. This is an emergency. If left untreated, the tissue in the white area could die from lack of blood flow. This happens because the hyaluronic acid gels take up space under the skin and can press on things. This is different from the action of Botox and Dysport, just to be clear,... more
Jessica J. Krant, MD, MPH

Manhattan Dermatologic Surgeon

www.ArtofDermatology.com

+1

Restylane - Restylane Perlane In the Glabella Area. The Injection Area Is Now White And I Have Dizziness. What Should I Do?

You need to contact your physician right away. This is an area of potential concern and you may have exactly the sort of problem that has been described. It is essentially some sort of occlusion (blockage) of the blood vessels in that region. It could be from direct injection of a vessel or, probably more likely, just too much pressure in that region. Because it is relatively tight skin over even more unyielding tissue (bone), it is a setup for a pressure phenomenon,... more
Alan Engler, MD

New York Plastic Surgeon

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