Nerve Damage After Dermal Filler?

Question

I had dermal fillers injected into my glabella, tear trough, cheek and naso labial folds 2 weeks ago. Since the injections I have had visual problems in my right eye and pain in my right cheek and was given a steroid pack/antibiotics. I went 3 days post injections to the opthalmologist who said my eyes were healthy. Visual problems are persisting, like a numbness in the upper inside eye socket, makes me rub my eyes and pull at my lid. Has a nerve or blood supply been damaged? Is it permanent?

Sam Naficy, MD, FACS · Answer

If you haven't already returned to your provider who performed the injections, you should ASAP. Considering all areas treated, you may have a potentially very serious occlusion and your symptoms and issues could worsen and definitely be traumatic. Without knowing specific details, it's hard to know for certain but a reputable provider would have a specific protocol to handle potential complications.

Jonathan Kulbersh, MD · Answer

Hello, and sorry to hear about the issue you are experiencing. In general, the side effects of dermal fillers may be as follow:

	1) Swelling
	2) Bruising
	3) Redness around the injection site
	4) Lumps or bumps

	It is not typical for dermal fillers to result in any type of eye pain or visual problems. The filler stays localized to the area it is injected and will not migrate anywhere else. Going to see an ophthalmologist was a good first start, and the recommended step to take. Did you explain to them that you were experiencing numbness in the upper eye socket, and any other issues? Preferably, this is something that a neuro-opthalmologist would have to address. Swelling can potentially compress a nerve and cause a problem. It is not possible to advise you on the status of a nerve or blood supply or the permanency of any issues without an exam. I hope this helps, and I wish you the best of luck.

Kenneth D. Steinsapir, MD · Answer

It is certainly possible to have filler product embolize into the orbital circulation and could account for some of your issues. A fluorescein angiogram can be performed to determine if there is any disturbance of the retinal circulation. A visual field can also detect any changes in the visual fields. Both of these measures may reveal abnormalities in the vision that can not be detected by simply measuring line visual acuity on an eye chart. If these measures are normal then it is likely that whatever you are subjectively experiencing will settle down with relatively little or no permanent issues. Sensory changes generally recover and although it is certainly possible to have long term patchy numbness, this would not be expected.

Nima Shemirani, MD · Answer

Dear Panicked,

	
		Have you seen your injector again?
	
		If the problem is not getting better, or getting worse, you should see them right away
	
		It is difficult to know exactly what to do next without knowing how the Restylane was injected, exactly where it was injected, and what your physical exam is like


	Best regards,

	Nima Shemirani

Chase Lay, MD · Answer

that's a very tough one to answer online. I would have another ophthalmologist see you preferably a neuro specialist.odd sensations feelings of pressure etc. are not strange but visual changes are concerning. Very specifically request to see a Neuro-ophthalmologist. I'm sorry couldn't be of more help at this time.

Nerve Damage After Dermal Filler?

Answers (6)