Filler danger zones — the vessels that can cause blindness, and how you inject around them
Can someone consolidate the key arteries behind the blindness risk with filler, and the practical rules for injecting safely around them?
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The high-consequence anatomy to know cold: • Supratrochlear & supraorbital arteries (forehead/glabella): terminal branches connected to the ophthalmic (retinal) circulation — retrograde embolism here can cause visual loss. • Angular/dorsal nasal (nose, medial cheek, NLF): the angular artery is the terminal facial artery and anastomoses with the dorsal nasal branch of the ophthalmic artery — again a route to the eye. Occlusion can blanch the lateral cheek/nasal septum. • Infraorbital artery (mid-cheek/tear trough): passes through the infraorbital foramen and anastomoses with the angular artery. Highest-risk zones: glabella, nose, nasolabial folds and tear trough. Practical rules: know the depth and vessel course, aspirate with a needle, consider a cannula, inject SLOWLY with low pressure and small aliquots, keep the needle moving, and never inject against resistance. And know your visual-loss/vascular-occlusion emergency pathway BEFORE you treat these areas — minutes matter.
Bookmarking this. The 'know the visual-loss pathway before you inject glabella/nose' line is the one I want every new injector to internalise.
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