When getting Voluma, how can you immediately tell the difference between a bad reaction (blindness) and a vasovagal response?

Vasovagal sensations, the feeling that you are going to pass out, are relatively common. When I treatment 100 patients, one or two may experience vasovagal symptoms. It is unpleasant. You feel very uncomfortable, anxious, light headed. These feels are disturbing and can evolve rapidly. When I sense this is going on, we simply stop treatment. I put the chair that my patient is in to a flat position. Laying flat, symptoms pass relatively quickly. Usually we will have them drink an apple juice because many of the individuals who are vagal forgot to eat or drink anything before their procedure. With the resolution of the vagal symptoms, the patient is sat up and the treatment is completed. If you are having an untoward event with a filler, you may not have vagal symptoms. What is common with patients who are having an interruption in circulation from filler is pain. The face hurts. Now how common is loss of vision from filler. Well no common. Last year there were something like 12 million filler services and perhaps 20 people went blind. The risk appears higher in South Asia and South Korea with perhaps 1/2 the cases related to these areas. That puts the risk of visual loss at 1 in a million. That is on par with the risk of getting on a commercial jet aircraft and it crashing. It does happen but it is so very rate that we get on commercial jet without worrying about it. Of course your risk of crossing the street and getting struck by a moving car is much higher by comparison. So if you decide to do Voluma what is your risk of loosing vision? So rare, that whatever you are experiencing it is much more likely to be vasovagal symptoms because it is 1000 time more likely. If you say that does not make you more comfortable, I would recommend not having filler treatments. It is safe but you need to do what feels right and that is not the same for everyone. 

Prevention of those complications should be first and foremost.
When you are getting treatments make sure you are lying flat and fainting rarely occurs while in that position.
Make sure your injector uses a 22 guage cannula to avoid placing filler in your arteries.
Blindness after fillers is noticed immediately or sometimes delayed after the injections and won't go away quickly like when you faint. It would only occur on one side. If it occurs it should be treated as soon as possible and hopefully will go away.

Hi LA Girl,The most important thing that you can do is make sure that you choose your facial filler injecting physician most carefully.  With experience, knowledge of facial anatomy, skill, and natural artistic vision the injection of Voluma should be extremely safe and effective.  We have treated hundreds of patients without adverse events or complications other than occasional minimal bruising. We would advise you to use relaxation breathing techniques during your Voluma treatment, if you show signs of a vasovagal reaction, we immediately stop injecting until you recover fully.  We have many patients like yourself who were nervous and anxious at their first injection visit who have returned many times finding their treatment very easy and reminisce on how far they have come where the injections no longer bother them at all.  Again, choose your injecting physician carefully and you should have nothing to worry about.  Good luck and be well.Dr. P Encino, CA 

Hello and thank you for your question. Blindness is an extremely rare adverse event with filler injections around the nose and eyes. It would be sudden and painless. Vasovagal reaction is quite common with needles among other causes. A specially trained provider to perform your cosmetic procedures would be able to avoid poor outcomes and respond to them appropriately.

I appreciate your concern, but let me assure you severe side effects like blindness are extremely rare with dermal filler injections. If it does occur, it is more likely with injections around the forehead, nose or eyes. You are already familiar with the symptoms of a vasovagal response - the symptoms of potential blindness would be sudden loss of vision in one eye that would not be accompanied by dizziness. There are techniques to help patients who develop vasovagal response that can reduce the chance of it happening. Knees up, apple juice and cold air during the injections are a few of these. Make sure you work with a board-certified dermatologist who is also an expert injector to ensure a safe and effective procedure. 

I appreciate your concern and assure you many patients deal with vasovagal responses when they receive dermal fillers. Blindness is an extremely rare side effect of this treatment, and is more likely to occur with injections to the upper face or around the eyes, rather than injections to the cheeks. Blindness would be characterized by a sudden loss of vision in just one eye. It would not be accompanied by typical vasovagal response symptoms like dizziness and lightheadedness. Make sure you work with a board-certified dermatologist who is also an expert injector to ensure your procedure is as safe and successful as possible. 

Blindness from fillers is an extremely rare complication from fillers especially when seeing a board certified physician who is an expert injector. See an expert to review risk and benefits of fillers. Best, Dr. Emer. 

Vasovagal responses with fillers can be common in some patients.   Make sure to eat prior to injections.  Some patients find listening to music or telling a story can be helpful.   Blindness from fillers is thankfully a rare complication from fillers.  And though it can happen, the most common areas that this has happened is in the forehead and nose.   Even in those areas, it is extremely rare.  Visual changes from filler would only happen on 1 side and would not be associated with lightheadedness or dizziness.   Best of luck.

Thank you for sharing your question.  Blindness would be seen nearly immediately but based on your history I would help minimize the risk of complications by having your injector use a cannula.  Hope this helps.

Vasovagal response to fillers is fairly common but can be avoided by having the patient lay down flatter during the injections and taking breaks if needed during the procedure. Fortunately voluma to the midface is a very quick procedure and the risk of a vasovagal reaction is much less than with lip injections. Blindness from injections is extremely rare and the risk can be further reduced by using a cannula, injecting only small amounts of filler in each location, and avoiding the high risk areas around the bridge of the nose.