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Facial Danger Zones: Techniques to Maximize Safety during Soft-Tissue Filler Injections

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

Plastic and Reconstructive Surgery: May 2017 - Volume 139 - Issue 5 - p 1103–1108
doi: 10.1097/PRS.0000000000003309
Cosmetic: Special Topics
Press Release

Summary: Given the short recovery and immediate results, facial fillers have become a popular alternative to surgical rejuvenation of the face. Reported complications arising from facial filler injections include erythema, tissue loss, blindness, stroke, and even death. In this article, the authors describe their anatomically based techniques to minimize risk and maximize safety when injecting in the facial danger zones, including the glabella/brow, temporal region, perioral region, nasolabial fold, nose, and infraorbital region. Complications generally arise secondary to vasculature injury and/or cannulation with filler. The authors have outlined their preferred injection techniques in the facial danger zones with respect to the pertinent anatomy in an attempt to minimize risk and maximize results. Most importantly, the practitioner should be able to recognize complications and address them immediately.

Supplemental Digital Content is available in the text.Video Discussion by David Sarwer, Ph.D., is Available Online for this Article.

Dallas, Texas; and San Francisco, Calif.

From the Dallas Plastic Surgery Institute and Sieber Plastic Surgery.

Received for publication April 25, 2016; accepted October 5, 2016.

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

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Rod J. Rohrich, M.D., Dallas Plastic Surgery Institute, 9101 North Central Expressway, Suite 600, Dallas, Texas 75231,, @DrRodRohrich

©2017American Society of Plastic Surgeons