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Anatomy of the Facial Danger Zones: Maximizing Safety during Soft-Tissue Filler Injections

Scheuer, Jack F. III, M.D.; Sieber, David A., M.D.; Pezeshk, Ronnie A., M.D.; Campbell, Carey F., M.D.; Gassman, Andrew A., M.D.; Rohrich, Rod J., M.D.

Plastic and Reconstructive Surgery: January 2017 - Volume 139 - Issue 1 - p 50e-58e
doi: 10.1097/PRS.0000000000002913
Cosmetic: Special Topic
Video Discussion

Summary: With limited downtime and immediate results, facial filler injections are becoming an ever more popular alternative to surgical rejuvenation of the face. The results, and the complications, can be impressive. To maximize safety during injections, the authors have outlined general injection principles followed by pertinent anatomy within six different facial danger zones. Bearing in mind the depth and the location of the vasculature within each zone, practitioners can tailor their injection techniques to prevent vessel injury and avoid cannulation.

Video Discussion by Jean D. Caruthers, M.D., is Available Online for this Article.

Dallas, Texas

From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Received for publication January 11, 2016; accepted August 23, 2016.

Disclosure:Dr. Rohrich receives instrument royalties from Eriem Surgical, Inc., and book royalties from Quality Medical Publishing and Taylor and Francis Publishing. No funding was received for this article. The authors have no financial interest in this research project or in any of the techniques or equipment used in this study.

A Video Discussion by Jean D. Carruthers, M.D., accompanies this article. Go to PRSJournal. com and click on “Video Discussions” in the “Videos” tab to watch.

Supplemental digital content is available for this article. Direct URL citations appear in the text; simply type the URL address into any Web browser to access this content. Clickable links to the material are provided in the HTML text of this article on the Journal’s website (

Rod J. Rohrich, M.D., 9101 North Central Expressway, Suite 600, Dallas, Texas 75231,

Copyright © 2016 by the American Society of Plastic Surgeons