A variety of filler materials (autologous fat, hyaluronic acid, etc) may be injected into the face for cosmetic purposes. A number of complications may occur, some of which are devastating. The possibility of these events needs to be included during the informed consent process.
Complications may involve:
(1) emboli (with visual loss, stroke or skin necrosis)
(2) infection
(3) migration
(4) extrusion
(5) other disfigurement (swelling, discoloration, etc)
Theories for embolic events:
(1) accidental injection into an artery proximal to the terminus
(2) pressure of injection is sufficient for filler material to back flow into a branch of the carotid artery
(3) communicating branches between the facial artery and intracranial arteries
(4) communicating branches between branches of the facial artery
It is important to exclude other explanations, especially for the embolic events and infection.
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