Dermal fillers: Can skin necrosis and nerve damage be completely avoided?

I need my upper cheeks plumped up because I lost facial fat. I am considering Juvederm for this (no micro-cannula method or Sculptra) but are terrified at the thought I might be one of the unlucky ones who gets their blood vessel blocked and develop skin death. Is there ANY method that guarantees this does not happen? A strong light to see under skin? Pierce and draw before injection? X-rays? Facial fat grafting and cheek implants are out of the question. Thank you.

Doctor Answers 2

Filler complications

Hello, and thanks for your question. 
I understand your concern and I am glad you're doing your homework. Unfortunately, there is no way to make any medical procedure 100% risk-free. However, well-trained experts use techniques (i.e., cannulas, slow injection, small boluses, etc.) to make these risks exceedingly low. To maximize the likelihood of a favorable outcome and minimize the risk of complications, I recommend that you only get treated by a well-trained and experienced dermatologist or plastic surgeon. 
Hope this opinion is helpful to you. Best of luck, Dr. Frucht.   

Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Filler complications

That is a very good question, and I understand your concern.  There unfortunate truth is that there is not one method that can completely eliminate any risk of complications.  There are, however, several techniques that can minimize those chances, which are already quite low.  The use of cannulas can help in that they are much less likely to penetrate (and occlude) a blood vessel.  Also withdrawing on the syringe prior to injection can help ensure that you are not in a blood vessel.  Avoiding large, forceful depot injections will also minimize chances, while improving your aesthetic result.  I will say that there are 2 areas where these complications occur more frequently, and those are the glabella and nasolabial fold areas.  You mentioned that you want to add volume to your cheeks.  You might consider a consultation for Voluma, as this is injected relatively deep, and theoretically below the blood vessels.  It is also injected in an area of the cheek with a good amount of collateral circulation that is not usually dependent on one blood vessel.  Good luck.

John Harbison, MD
Omaha Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

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.