A very high risk filler area: between the eyebrows

I had Juvederm injected into the crease between my eyebrows. I had the standard "bump" when I left the office. Next day, my face was swollen. The day after, the area under my eyes looked bruised and discolored. A week later I was still swollen and bruised and my jaw began to hurt. I went back in and they used a product to dissipate some of the filler. It swelled again and so did my face along with fluid retention under the eyes and discoloration. They won't refund me and I don't want them to inject me with anything anymore. What could have happened? Thanks

I’m sad that this happened to you. If you’re still having filler problems, please go ASAP to another dermatologist or plastic surgeon in the area who injects a lot and have them look at you and possibly treat this again.  You may need more hyaluronidase (Vitrase or Hylenex brand names) injected into the area to restore full blood flow.

It is not possible to know for sure at this point, but it’s likely that an artery in your forehead was partially blocked by the filler treatment. The forehead “11” lines are a VERY HIGH RISK AREA  for artery blockages with fillers (not Botox or Dysport). This can result in neighboring tissue not getting enough blood which can cause skin distress and even skin death (necrosis).  If skin death in an area occurs, a large scab will form and there may be scarring.

More on filler safety here.

Please, please don’t let anyone inject in this area (forehead between the eyebrows) who is not an expert injector.

Things to look for in an expert injector for your brow area:

An expert injector is a

  • board certified dermatologist or plastic surgeon
  • someone who works with these products on an almost daily basis
  • has at least 10 years experience injecting
  • and who has a good reputation generally and respect in your community.

There are some nurse injectors now in various cities who are excellent and also meet these criteria.

Also, small to medium size bruises are normal after filler injections, especially if you forgot and took aspirin, ibuprofen, Advil or Aleve, etc. in the week before your treatment. But, if a bruise is unusually painful, large, dark, mottled or  different from your normal  bruises, call you doctor or provider and notify them. They really should look at you or at least have you send a photo to check the area!

Hope this helps, Dr. I

Dr. Brandith Irwin, MD

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