Doctors warn of the risk of blindness and stroke after cosmetic filler injections

On August 6, Associate Professor, Doctor, Doctor Nguyen Huy Thang, Head of the Department of Cerebrovascular Diseases, People's Hospital 115 (HCMC), said: Dermal filler injection is a technique commonly used in cosmetic surgery to remove wrinkles. However, recently, many dangerous complications such as stroke and blindness related to this technique have been reported, with an estimated 100 cases worldwide. Recently, at People's Hospital 115, there were 3 cases of such complications.

A typical case is the case of Mr. NVH (21 years old, Dong Nai) who injected feng shui filler into his nose at a place selling sticky rice and bread. Five minutes later, the patient had a headache with vomiting, pain in the right eye - blurred vision, dizziness, had to be admitted to the Emergency Department of People's Hospital 115, and then transferred to Cho Ray Hospital for further treatment. Verification showed that the filler was purchased online by a woman for 300,000 VND and injected into Mr. H.

Recently, on August 3, the Inspector of the Ho Chi Minh City Department of Health informed about a 39-year-old female patient who suffered a serious medical accident after injecting filler at an unlicensed facility. The female patient was taken to the emergency room with a diagnosis of total uveitis in the right eye and central retinal artery occlusion. Skin ischemia in the right forehead, right eye, and nose was monitored after filler injection.

Even though it is only injected subcutaneously, hyaluronic acid molecules (contained in fillers) can still enter the arterial system.

Causes of stroke and blindness after filler injection

According to Dr. Thang, no one can be sure that the filler is not injected directly into the blood vessels. When it enters the blood vessels, the filler can cause retinal artery embolism, which can cause permanent blindness or cerebral artery embolism, causing cerebral infarction. Recently, the US Food and Drug Administration (FDA) has warned about these complications, and has only approved the injection of fillers for cases of wrinkle removal in the lower face (around the lips).

Among the fillers, about 80% of the cases used are hyaluronic acid - a large sugar molecule that can hold a large amount of water (500-1,000 times its weight). That is why many women especially favor this type of beauty.

The problem is how hyaluronic acid molecules can enter the arterial system when only injected subcutaneously. According to Dr. Thang, it has recently been found that hyaluronic acid molecules can penetrate the skin and blood vessels. However, the possibility that these extremely small molecules can cause retinal artery or ophthalmic artery embolism is very unlikely. Thus, the possibility of direct injection into the alar artery is the most likely possibility. After entering the blood vessels, the filler can cause retinal artery embolism, which can cause blindness or cerebral artery embolism leading to stroke. To date, there is no specific treatment for this accident. Even if the patient comes early, thrombolytic therapy with tPA is probably not beneficial because it is not suitable for the mechanism and can increase the risk of bleeding.

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