What is the risk of injecting filler in the nasojugal groove area?

The nasojugal groove/fold can run directly over an area in the face where a large artery and nerve are located. This area can be injected with certain types of dermal filler (Sculptra is not usually intended for use in this area of the face) but, there are anatomical differences from person to person- so while one person may be a candidate, another may not. Having a provider with a thorough understanding of facial anatomy and injection techniques, such as cannula use, can help minimize risk. 

This area is often considered an advanced area for injectors so often for less experienced injectors they will avoid this.  There is a certain level of bone that sits beneath this area and as long as you stay within the boundaries then you are generally safe.  However, if you inject above this bone then you can cause serious harm to eye.  This is extremely rare and would require multiple errors to occur.  Most mistakes though are done by injectors who inject too superficially and this results in lumpiness which looks quite bad.  Also, in this area, it is more common to bruise so poor technique can potentially cause bruising that lasts weeks.  If you are interested in this area, you must seek out highly experienced injector who has done countless times to minimize these risks and get the best possible result.

All filler injections carry the same risk, regardless of area injected. Nose filler, jawline filler, and lip filler are the highest risk areas. knowledge of vascular anatomy(both location and depth) is something a skilled injector should have. Further safety can be achieved by using canulas, which do not have a sharp tip, making it extremely difficult to pierce a vessel. Particulate fillers like sculptra and radiesse carry a higher risk than gel fillers. Nasojugal injections can be safely done with hyaluronic fillers injected with a canula. 

There are several areas in the face that can be considered "danger areas" when injecting fillers. The nasal jugal fold or melolabial folds are one area. At the base of the nose is an area where vessels supply the nose and lips. Care must be taken to not inject into a vessel or compress a vessel. It's best to see an experienced facial plastic surgeon or dermatologist. 

This is a more advanced injection requiring more advanced anatomic and injection knowledge. That being said, it can be safely done in the appropriate patient. I prefer to use Restylane for this indication and inject it using a microcannula to minimize bruising, swelling and risk of vascular injury. 

There are vessels in the face that must be avoided during injections.  With that said, fillers of the face may be performed safely with the proper techniques and tools.  For instance, injecting on withdrawal, using blunt cannulas around the eyes, and having reversible agents such as hyaluronidase readily available are some of the options in maintaining maximum safety.

Hi,Tear trough injections are possible but have to performed by an experienced injector. There have been reports of injection compressing or occluding arterial blood supply but they are extremely rare. If you have it done by a highly experienced surgeon the risk is minimal.Best,Dr.S.