What are the risks associate with injectable fillers if you have Factor II Gene Mutation (Prothrombin)?

Question

I'm considering fillers. What are the risks associate with fillers if you have Factor II Gene Mutation (Prothrombin)? Are there better fillers than others? I've read with Radiesse, for example, you shouldn't get it if you have a "bleeding disorder." I'm not on a blood thinner or aspirin, etc. Is it safe for me to get fillers for hollow temples, marionette lines and nasolabial folds? Thank you for your time!

Jo Herzog, MD · Answer

I would have more concern with a patient having a disorder that increases bleeding but that would not prohibit injection, I would just warn them that they were at increases risk of bruising. I do not see how a disorder with increased clotting would interfere with use of fillers.

Neel Bector, MD · Answer

Prothrombin mutation is a condition associated with high risk of blood clot formation in major blood vessels of the body, mainly in legs, arms and lungs. In a person with factor 2 mutation with an insult to a vessel, blood  clots at a faster rate. Having said that, while injecting a dermal filler we are more concerned about the area being injected, if it is richly blood supplied then risk increases. While injecting filler all these aspects are assessed and its injected in a safe zone. Also, complication with hyaluronic based filler, which can be dissolved with the enzyme, hyaluronidase are usually minimum. 
I would recommend a thorough discussion about your situation with your doctor prior to procedure.
Regards,
Neel Bector

Steve Fisher, MD · Answer

The risks of a Prothrombin mutation usually include a higher incidence of forming blood clots in blood vessels.  This is not typically what we are most worried about when we are doing deeper injections of dermal fillers in a patient; we usually worry about conditions that thin the blood and lead to an increased risk of heavy bleeding.  The most worrisome effect of having a prothrombin mutation is of having blood clots form in the larger deep veins of the legs or arms (DVT) or lungs (PE).  That said, it's hard to predict whether your condition could predispose you to having complications of a local injection in your face, and potentially lead to blood clots forming in the smaller blood vessels causing the feared complication of skin breakdown, or necrosis.  You're certainly right, that a non-dissolving filler such as Radiesse would be less safe than a hyaluronic based filler, which can potentially be dissolved with the enzyme, hyaluronidase.  If a significant blood clot does form, however, it may not matter which filler was used.
I would have a frank discussion with your doctor about the potential risks vs. benefits from using dermal fillers with your condition.

What are the risks associate with injectable fillers if you have Factor II Gene Mutation (Prothrombin)?

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What are the risks associate with injectable fillers if you have Factor II Gene Mutation (Prothrombin)?

Answers (3)

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Everything you need to know about Dermal Fillers

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