Injector Hit Nerve in Cheekbone W Juvaderm and Eye Twitching?

Question

I had half a syringe of juvaderm injected into both of my cheekbones. The injector hit a nerve on my left side and said that side would be more swollen since she hit the nerve there. 3 days later the swelling is gone but the area where the nerve was hit is a tad lighter that my skin color and a bit hallow and hurts and my cheeks look not proportioned. My eye on the side where she hit the nerve has also started to twitch ALOT. Please help. Will the twitching go away? Could it be the nerve causing it?

Jonathan Kulbersh, MD · Answer

Hello, and sorry to hear about the issue you experienced following your treatment. Hitting a nerve during a Juvederm treatment is rare, and can lead to the following:

	1) Numbness
	2) Tingling
	3) Swelling

	Your disproportional cheeks are due to swelling, and I would need to see you in person to determine the cause of the lighter skin color. If you are experiencing twitching, this is not likely due to hitting the nerve. I would recommend following up with your physician who performed the treatment right away, as the twitching could be due to another issue that needs attention. The nerve is not likely the cause, but it should go away over time. I hope this helps, and good luck to you.

Kenneth Hughes, MD · Answer

Twitching, which would imply movement and motor nerve, NMJ, or muscle abnormality, would not be caused by injection into or around a sensory nerve like the infraorbital nerve.

Sam Naficy, MD, FACS · Answer

Yes, undoubtedly this will resolve with time.  Most likely it is a sensory nerve not a motor nerve and it should heal in a few weeks

Daniel Yamini, MD, FACS · Answer

Normally there are no major nerves near the cheekbones that can be injured during a Juvederm injection. The only major nerve and blood vessel in the region is under the eye. Sounds like you may have had some bruising and swelling that may have caused the twitching and asymmetry. This always goes away as the swelling resolves. You can alternate warm and cold compress to accelerate the healing. If the symptoms persist visit your doctor. The color change is not due to hitting a nerve but possibly from injecting the filler too superficially. If you are not pleased with the result, you can inject the antidote (hyaluronidase) and start over.

Ramona Behshad, MD · Answer

There is a sensory nerve (infraorbital nerve) that lies along the upper cheekbone that can be irritated by filler injection. That nerve, however, does not control muscle movement (i.e. twitching). Trauma to the nerve, however, can cause swelling and pain that takes a few weeks to resolve. As long as there is no allergy or intolerance, NSAIDs (such as ibuprofen, naproxen) can be helpful for nerve inflammation. It is certainly worthwhile to consult with your provider first, especially if the twitching lasts longer than the swelling.

Injector Hit Nerve in Cheekbone W Juvaderm and Eye Twitching?

Answers (6)