Glabellar region filling: examining the reasons for the high incidence of complications and blindness

Introduction: Fillings are currently one of the most sought-after treatments for aging. The glabella area is subject to complications arising from the application of fillers, the most common of which are transient erythema, granulomatous reactions, arterial occlusion, and blindness. Nevertheless, the pathogenic mechanisms that lead to a loss of sight following the injection of fillers in the glabellar region remain unknown. Objective: To evaluate the percentage of patients with severe obstruction of the internal carotid artery who present carotid flow reversal, in order to demonstrate a possible cause of a higher incidence of complications linked to the use of filling substances in the glabella. Methods: Prospective study carried out with duplex scan at the Radiology Department of the Hospital de Base de São José do Rio Preto, São Paulo, Brazil. Results: Advance detection of carotid flow reversal (external to internal carotid system) – which is a common event in patients with a hemodynamically significant obstruction of the internal carotid artery – can prevent serious consequences – the most critical of which is blindness. Conclusion: Filling procedures in the glabellar region must be avoided due to the risk of carotid flow reversal and subsequent occlusion of the central retinal artery, which causes blindness.

Keywords: CAROTID ARTERY, INTERNAL, BLINDNESS, GLABELLA