Can Restylane Injected in the Tear Troughs Cause Blindness?

Will Restylane (injected in tear trough) enter blood stream and cause blindness? I am deeply concerned about reports claiming that the molecules of hyaluronic acid (from Restylane injection in tear trough) are small enough to penetrate into the blood stream , resulting in blindness as it block the blood vessel. Is this true? Thank you.

Doctor Answers 6

Fillers in the tear trough can theoretically lead to blindness but there are precautions that you can take to prevent it.

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.

Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 86 reviews

Restylane in tear troughs should be placed very carefully

The blood vessels around the eyes have unique features that make injection into the tear trough and malar region a procedure that should only be done by experienced injectors. The issue is embolization of the filler (any type of filler- no just Restylane) into the blood supply of the retina. This would occur if the injection needle pushed he filler directly into the blood vessel. The mere presence of filler in the tear trough region poses no risk for embolization. The act of injection into this area does. Seek out a board certified plastic surgeon with experience in injection into this region of the face.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

Theoretically injecting Restylane in the tear troughs can cause blindness

Theoretically injecting Restylane in the tear troughs can cause blindness. If the Restylane is injected improperly, it can block an artery and lead to blindness. However this would be extremely rare. It’s always good to go to an oculofacial plastic surgeon for any injection done around the eye as they are specialists trained specifically in the anatomy of the eye and the delicate surrounding structures.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 66 reviews

Restylane around eyes

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.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 73 reviews

Theoretical risk of blindness from fillers near the eye

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.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Tear trough injections and blindness

Blindness is an extremely rare occurence that can happen.  Injecting fillers anywhere can potentially get injected into the blood stream.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 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.