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Periocular complications require timely management

Article-Periocular complications require timely management

Periocular complications from aesthetic procedures happen, even from seemingly low-risk filler treatments, and physicians’ timely management of those issues is critical, according to Cosmetic Surgery Times advisor plastic surgeon Jason N. Pozner, M.D., Boca Raton, Fla., who spoke to colleagues during the 36th Annual Conference of the American Society for Laser Medicine & Surgery, Boston, Mass.

Fillers and devices can cause a spectrum of complications, he notes.

“[Regarding] filler injections, the worst complication (which thankfully is very rare) is blindness from intraarterial injection,” Dr. Pozner says.

Other filler-related complications, such as lumps or a Tyndall effect, result from using the wrong or too much product, according to Dr. Pozner.

Device-related periocular complications can occur when physicians use the wrong device or cause too much injury, which may lead to scarring. Complications related to laser and other devices span from globe injuries (from lasers) to capillary fragility, ectropion and skin eruptions.

“Most laser complications on the eyelids are similar to other areas and include viral, bacterial or yeast infections, as well as hyperpigmentation or hypopigmentation,” he says. “Allergies or reactions to the products used can occur. It’s also not uncommon [to see] synechia — when lasered skin sticks together.”

Simple tips to avoid complications include injecting fillers around the eyes slowly and paying attention, according to Dr. Pozner.

“Have your plan and needed materials available for intravascular injection,” he says. “It’s not the best time to search for things after [a complication] happens.”

When operating devices, doctors and patients should practice good eye safety.

“No shortcuts,” Dr. Pozner says.

Finally, don’t underestimate the importance of good follow up, to catch problems early, before they become big, difficult-to-treat and potentially devastating complications, he says.

Disclosure: Dr. Pozner reports no relevant disclosures.

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