As with any medical procedure there are some risks to consider. Most patients will have some degree of swelling associated with this treatment, but this will settle over the following few days. There may be some discomfort, bleeding or bruising. There have been cases in Australia of vascular injury whereby filler is inadvertently injected into a blood vessel. It is very rare but if it occurred could lead to necrosis of the skin or visual loss. A thorough knowledge of facial anatomy and safe injecting techniques can greatly minimise this risk, however if any signs were to occur the filler would need to be dissolved immediately.
It should be pointed out that this is a common area for bruising to occur due to thin skin and multiple blood vessels in this area. There are certain techniques that can be used to minimise this risk and, although it does not happen commonly, should be expected. Therefore, filler in this area should not be considered if there is a special event that you are planning in the next fortnight where a bruise would not be acceptable in case this should occur. However, if it does occur it can be minimised by applying ice for 24 hours afterwards and camouflaged with makeup.
The other consideration of filler in the tear trough deformity is a poor aesthetic outcome. This can occur for several reasons, including:
- Filler placed too superficially in the skin. This can lead to a blue appearance in the skin (known as the Tyndall effect).
- Too much filler used (or overcorrection) causing ‘puffiness’ under the eyes. This is why the procedure should be performed over two visits.
- Performing the procedure on the wrong patient. Identifying patients who will not get a good outcome is vitally important in tear trough filler. Common times when it would not be appropriate are in patients with poor skin laxity, large eye bags or seasonal allergies.
It is for these reasons that it is important to see an experienced cosmetic physician with a good knowledge of facial anatomy and who understands how to avoid complications so that you can get the best possible outcome in the safest way.