I got Restalyne on my forehead on Friday (for a scar/wrinkle). By Saturday night I had a big red, bumpy spot on my forehead. (Ph

Question

Monday RN/injector prescribed prednisone/arnica. It feels less bumpy and looks better in the mirror (looks awful in the close up pic). After reading reviews I'm scared it's necrosis and I might go blind. Do you think it's necrosis and can I go blind?

Jason Emer, MD · Answer

It's difficult to tell from your photos. The redness can indicate intravascular occlusion or blood vessels compression and I suggest you see your physician right away.  This can be reversed with hyaluronidase and should be treated with topical vasodilators (nitropaste) as prevention.  Blindness in this area is rare, necrosis is possible if you do not see your physician and this worsens.  See an expert. Best, Dr. Emer

Kyle Coleman, MD · Answer

Restylane and other fillers should only be used in the forehead by experienced injectors.  Not only is it a high area of concern for vascular inclusion, it is also an area that is often overtreated leading to odd appearance or over correction.  It does not appear from the pictures to be a vascular occlusion event; however, the pictures are difficult to examine.  I would seek out an expert injector (physician only) in your area to be examined for evaluation and treatment.  Best of luck.

Kenneth Yu, MD · Answer

Hello.  It's hard to give a good answer based on your photos.  Generally, Restylane is not an ideal filler for the glabellar and forehead regions.  Injections in the glabellar region must be done extremely cautiously-- if at all--due to known risk of embolization.  Blindness can be a catastrophic complication.  Your concerns about possible necrosis and vision loss are serious and you should see a board certified doctor as soon as possible.  Only an in office exam can determine what's going on and intervene if necessary.  Good luck.

William Marshall Guy, MD · Answer

Hello Tracey C,I am not a fan of injecting fillers into the forehead for various reasons.  You had indicated you were concerned about the risk of blindness and skin necrosis.  Blindness has been documented with filler injection in those areas, but the effect was immediate.  So you don't have to worry about that. Skin necrosis is also more prone to the forehead area and shows up as increasing pain and skin colors within 24-48 hours.  That is also very rare, but best evaluated in person.  It sounds most likely that you are either having a reaction (exceedingly rare) or possibly an infection.  I would recommend you continue with close follow up your injector, and in the future only receive injections from core aesthetic physician injectors.I hope this helps and good luck.

Melvin Elson, MD · Answer

Even though the pictures are not helpful I don't think you are having a necrosis episode as these are very painful.  It is probably irritation and overcorrection which will subside. it sounds like the nurse is taking good care of you and rest assured you will not go blind

Anthony J. Taglienti, MD · Answer

Thank you for your question. If you are not having extreme pain - which is usually a tell-tale sign of vascular occlusion and can lead to potential necrosis - then you are probably ok. However, you definitely need thorough follow-up - and the area should not be as red as it is (unless you placing ice on the area?). I would suggest keeping in close contact with your injector - the other potential interventions are 1) dissolving the filler and 2) placing you on an antibiotic. If you have any questions, please seek out a Board Certified Plastic Surgeon in your area. Best of luck!

F. Victor Rueckl, MD (in memoriam) · Answer

I'm so sorry to say that it is really hard to tell in your photo if that is vascular occlusion or just a bruise and swelling. Restylane is a bit thick of a filler to be putting into the forehead area. Unfortunately I've seen several vascular occlusions in this area from inexperienced injectors. I would suggest you find an MD in your area and be seen ASAP. I'm sorry I can't tell more from your photo. Other things to note would be a great deal of pain (like blood isn't properly flowing through - because it isn't!), small bumps will start to occur on the surface, and heat will sometimes occur as well.  "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

I got Restalyne on my forehead on Friday (for a scar/wrinkle). By Saturday night I had a big red, bumpy spot on my forehead. (Ph

Answers (7)

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