Can Restylane Injected in the Tear Troughs Cause Blindness?

Fillers in the tear trough can theoretically lead to blindness but there are precautions that you can take to prevent it.  The veins around your eyes and nose and center of the face are valveless and do not prevent particles from traveling back into the deeper tissues like your eyes and brain.  It is possible to cause the particles that are injected with fillers to go back into the eye to cause blindness.  But this is extremely rare.  You can take some precautions to prevent this though.  When you inject, you should not apply to much pressure with injecting.  Also when you inject it you should never be in one place and your needle should always be moving and distributing the filler evenly.  This prevents a load of filler being place in one spot and in the case that you are near a vessel the one spot is not being filler aggressively and possibly back into deeper structures like your eye. Also local anesthesia prevents the vessels from being injected by constricting the vessels so that it is less likely for the filler to get into the vessels.

There is a theoretical risk of occluding a vessel from restylane injection, however that is very very rare around the eyes, especially if the restyalne is injected via proper technique and correct location/plane.

Dr T.

There is a theoretical risk of blindness when fillers are injected near the eyes, and even between the eyebrows. There are fortunately very few reported cases of this in the last few decades since collagen injections were developed. Slow injections, delivery of filler product during movement of the needle, and watching for any unusual response from the patient, helps the doctor minimize this already extremely low chance of a complication from happening. If a hyaluronic acid is used such as Restylane and Juvederm, theoretically there is a possible treatment that might successfully treat this complication which would be the injection of hyaluronidase into the vessel which could dissolve the filler. if a thicker product is used, there would not be such a possible solution. Make sure you see a board certified dermatologist, plastic, facial plastic or oculoplastic surgeon who is experienced at these injections for a consultation.