Cosmetic fillers can cause blindness, plastic surgeon warns.

Those considering getting cosmetic fillers need to be careful, Australia’s plastic surgeons body has warned. Studies show there is a “small, but significant risk” of instant and irreversible blindness.

The warning comes as a study published in July’s issue of the Journal of The American Society of Plastic Surgeons confirms exactly how a mistake by the injector can lead to the patient becoming permanently blind in the affected eye.

Australian Society of Plastic Surgeons president Professor Mark Ashton tells Mamamia that consumers needed to be wary as worldwide there have been more than 100 cases of patients going blind.

Listen: The modern ethical dilemma. Post continues… 

“People need to know there are risks involved… and in a small, but significant proportion of people that risk results in blindness which is instantaneous and permanent.”

A 2015 study examined the complication and this recent study shed further light on just how it happens.

Dr Ashton explains that if the person performing the injection accidentally injected the filler into a facial artery, the filler could then flow through straight to the eye and block blood supply to the retina – causing it to die.

The result is permanent blindness in whichever eye is affected, which in some cases, was both. There are no recorded cases of it being reversed, Dr Ashton says.

It’s a terrifying fact, but Dr Ashton explains it isn’t a common complication and the risk could be minimised by customers ensuring they are receiving the injections from properly trained professionals.

So how do you know if the person you're seeing is qualified?

Well, they're either going to be a surgeon, GP, dermatologist or registered nurse - which one isn't important. What is important, Dr Ashton tells Mamamia, is what type of training they've received.

For one, the injector needs to have expert knowledge of the vascular anatomy of the face (know where the veins are) and be able to explain to you that they're using injection sites away from arteries.

The medical professional also needs to be using a technique known to lower the risks of complications, which Dr Ashton says is injecting "small doses using a continuously moving needle".

To find out if they know their stuff, Dr Ashton advises asking them.

"If you go to a clinic and you can't see evidence of appropriate and significant training or if they're not able to explain to you about the vascular anatomy of the face and how they're going to prevent the filler complication... then I certainly wouldn't risk having fillers in that facility."

Dr Ashton explains it isn't the type of filler that matters either. While a modified version of the hyaluronic acid, found naturally in the body, has replaced collagen as the most widely used substance for fillers, blindness has also occurred in cases where collagen or fat was used.

He adds that there were places for injections that posed a higher risk that others. The glabella (the smooth part of the forehead above and between the eyebrows), the nasal region, the nasolabial fold (laugh lines running from the side of the nose to edge of the mouth) and the forehead are all parts of the face where the complication has occurred.

Dr Ashton explains it doesn't matter that these areas are not near the eye, as all the nearby facial arteries lead to the ophthalmic artery and the eye. He also told Mamamia that blindness always happened seconds after the injections - so you're not at risk of the complication occurring days or weeks after you've had it done.

Be aware of the risks.

The ASPS goal in speaking out isn't to scare you silly. It's to make people aware of the risks involved in cosmetic injectables such as botox and fillers, Dr Ashton says.

"There's been a downgrading of the risk associated with fillers because they're becoming increasingly popular. (Consumers) don't perceive the injection as being one that has a potential risk. They might liken it to having a haircut."

Dr Ashton says clinics marketing these procedures as "non-invasive" were adding to a false sense of security, using the language as a way of implying the cosmetic procedures had minimal or no risks.

"There is no such thing as a risk-free intervention."

"If they're saying 'non-surgical' or 'non-invasive' what they're trying to do there is saying that surgery has a risk, but because we're not using a scalpel then the risk is minimised," he tells Mamamia.

"Even though it's not invasive and even though you're not using a scalpel there is a real risk involved with these procedures and training and expertise is absolutely critical in ensuring you get the safest and most reliable result."

He warns there was also the risk of soft tissue damage in the face. Thankfully this could be reversed, but only within a few hours of the procedure - anther reason to ensure the injector is properly trained and can pick up on signs of facial damage before it's too late, Dr Ashton says.

So what do I do now?

If you are considering getting a cosmetic filler, make sure you talk to the medical professional doing the injecting before the procedure to ensure you're confident in their knowledge and experience, Dr Ashton says.

"The take-home message is that there's a small, but significant risk and that this can be minimised by ensuring that the person doing the filling is able to demonstrate to you that they have undergone appropriate training, that they're aware of the facial vascular anatomy and that they are going to use a technique which has been shown to lower the risk of inadvertent intraarterial injection (and therefore blindness)."

"If you have any concerns then don't just go along with it. Say 'no stop, I think I might go to someone who's appropriately trained'."

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