Fillers are a generally safe approach to instantly achieving a new, refreshed look. While complications are uncommon, there is still the possibility of infection if the proper precautions are not taken.
Usually less than 10 percent of the patient population is susceptible to infection, according to Raymond Douglas, M.D., board certified aesthetic orbital and oculoplastic surgeon. Although, he says the eye region is particularly vulnerable and should be treated as such, meaning it’s important for medical spas and patients alike to be aware of the risks of facial fillers.
"It is easy to forget that although generally very safe and made of a non-immunogenic naturally occurring material found in the connective tissue matrix, this is still an implant, albeit liquid, with no blood supply, penetrating the skin,” Douglas says. “When done improperly, or when bacteria enter the site, the body can react trying to fight off an invasion or battle an infection if it occurs."
During the filler process, the needle or cannula moves back and forth, dragging skin cells into the point of penetration. If these skin cells contain certain bacteria, it can create a biofilm around the filler causing the implant to become infected.
If the filler becomes infected, there will be a few symptoms that are clear signs. Douglas shares that the area will initially take on the Tyndall effect – causing it to appear lumpy with a blue hue. The area will also become overly swollen and puffy, red, itchy, and inflamed. If the area continues to harden or develop malar mounds, the filler is likely infected.
Infections can range from low-level and mildly symptomatic to high alert cellulitis. If the infection is left untreated, the cellulitis of tissues around the eye can infect the socket and lead to vision problems or vision loss. If an infection from the filler develops, patients should see a medical professional immediately. The filler should be dissolved with hyaluronidase right away and treated with antibiotics.
So, what should you do to prevent an infection? According to Douglas, it is essential to clean the skin with antimicrobial and anti-bacterial skin cleanser before the procedure. The tools and product must be properly sterilized, and the procedure should take place in a clean environment. Make sure to choose a provider that has an extensive and advanced understanding of product placement. For example, an experienced professional will know that the injection should not go above the bony rim for under-eye troughs. It is also beneficial to use fat with a blood supply and to modify the technique used to minimize oscillation.