There is a small risk of blindness with any injection of something that can get into and block a blood vessel connecting back into the eye - not just filler. It is primarily discussed relative to injections of the temple or side of the forehead so those areas must be approached with that in mind. However, those areas are not injected when treating the tear trough, that hollow 'valley' running from the middle corner of the eye in an arc over the cheek that creates 'dark circles' or puffy looking lower lids. That doesn't mean zero risk, but it is not the primary risk. To create a naturally improved tear trough, we need to evaluate where the loss of volume is that created it. For most patients, its best to start with filler deeply on the upper outer cheekbone and then move more centrally along the upper cheek. Pull that area up while looking in the mirror and you see the effect. Injecting directly on bone with a needle or using a blunt tipped cannula reduces the risk of injecting into a blood vessel. Moving from the side to the center below the orbital rim (the boney edge of the lower lid) provides support and lifts the skin and avoids the creation of that overly filled look in the middle we've started to see. Although the cheek can be injected with numerous types of fillers, injecting directly into the tear trough is best limited to hyaluronic acid gel fillers which can be dissolved if necessary for cosmetic or medical reasons. Discuss the risks and options with your physician prior to treatment.
