Sometimes injectable fillers can cause blindness. Could xray devices like shown below protect customers from that? (Photo)

I want to inject fat or juviderm in my 11 wrinkles between eyes.I recently found out that if the filler gets in blood vessel- you're blind.I wanted to know if these devices(VeinViewer and Evena)could help doctor to see blood vessels on forehead and give a customer 100% protection from getting blind?I know that it is incredibly rare in a first place,but the consequences are too devastating.

Doctor Answers 6

Injectable fillers for under the eyes and viewing veins NYC

The view finder is a good idea for finding veins.  However, the arteries are the ones that can occluded and cause blindness.  Best, Dr. Green

New York Dermatologist
5.0 out of 5 stars 76 reviews

Veinfinder for filler injections to reduce blindness risk?

These are only good for veins, not arteries. Arteries are the ones which can lead to visual loss when injected. There are about 100 cases in the literature of visual loss with fillers. All were permanent. This is an extremely low percentage given the amount of injections being done. Half of these were from fat injections. The areas at risk are: glabellar, periorbital, nasolabial, temples. Picking the most skilled injector is the most important factor to minimize your risks of complications.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Filler safety and Reducing risks

Dear Hakunamatata,

This is a great question and good for you for being aware of the risks of filler in this area. To treat stubborn 11 lines, please always consider getting a toxin like Botox first in the area. Injecting filler in the 11 lines without toxin first is not very effective because the muscles that make the 11 lines will crunch out the filler as they move. Over time, getting Botox in the 11 lines will help smooth them out and make deep crevices less deep. If you still would like a smoother look after the 11 lines are treated with Botox, I love to use a device called a cannula to inject filler. A cannula is a shaped like a pipe so the end is not sharp like a needle. Therefore the risk of piercing a vessel is very very small. The VeinViewer is not helpful like it may seem- but a cannula makes the procedure very safe.
Good luck!!

Morgan Rabach, MD
New York Dermatologist
4.8 out of 5 stars 20 reviews

Veinviewer and risk of blindness from fillers

This is a good question.  These types of devices are more likely to show superficial veins rather than arteries.  They could be useful prior to Botox or filler injections to try to reduce the risk of bruising from the needle hitting a vein.  However, it is unlikely that these devices would be useful to reduce the risk of intra-arterial injection, which is the most worrisome complication.

The risk of intra-arterial injection or blindness from filler injection can never be eliminated completely, but the risk is extremely low in skilled hands.  I often inject the glabella with fillers.  I use an HA filler such as Belotero and inject very superficially, in the dermis, for etched-in vertical lines.  It is usually best to start with Botox (or Xeomin or Dysport) to the glabella first, and only use fillers there if needed after that.  The most important decision that you need to make is WHO to trust to inject your filler and/or Botox.  By the way, I don't recommend fat injections to the glabella.

Dr. Ort

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 25 reviews

Vein Viewer is NOT useful while doing facial fillers !

These devices are NOT useful at all in injecting dermal fillers. I use these devices for my vein practice daily. You can't shine this on someone's face and see how your injecting technique is doing. Plus, these are veins and the vascular structures that cause problems with fillers are most likely to be arteries. These devices do not show arteries or arterioles. 

So, the answer is :  they would be a complete nonsense to use for cosmetic rejuvenation of the face. 

If you are in sales, don't pitch to those who are doing fillers. It would be a complete failure. 

Dr H Karamanoukian
#RealSelf100 Member

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

Fillers - can the risk of blindness be reduced to zero

Thank you for asking about your Juvederm injections.

  • Yours is a very good question -
  • The answer is no - you cannot get 100% protection from injection of filler in this area.
  • In this area, there are multiple veins throughout the muscles which lie directly beneath the skin.
  • To reduce the risk, local anesthetic with epinephrine will shrink the blood vessels.
  • That said - it is the most risky area for filler injection. 
  • And I don't know how rare vision damage really is - I have a patient who mentioned in passing that elsewhere she had filler in the area and lost half her vision in one eye. A colleague knows of another case.
  • Botox - done regularly every 3 months - is the best and safest treatment.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.