Dermal Fillers

When injecting Juvederm®, Dr. Leveque, Dr. Patterson, & Dr. Butler may use small disposable cannulas. These cannulas are not larger than the standard needles packaged with Juvederm®; however, they and many other plastic surgeons have found that injecting Juvederm® with cannulas is safer and causes less bruising because the dull cannula tip is less likely to enter or cut small blood vessels.

If you have a history of cold sores, your plastic surgeon will place you on prophylactic Valtrex® a few days prior to having any injections around your mouth. This will help prevent cold sore (Herpes simplex) eruptions after filler injections.

Restylane Silk® is a lower viscosity HA filler that has many applications. Restylane Silk® is very useful for filling fine wrinkles around the eyes and lips, as well as treating the tear trough area under the eyes. When injecting Restylane Silk®, Drs. Leveque, Butler, & Patterson may use small disposable cannulas. These cannulas are not larger than the standard needles packaged with Restylane Silk®; however, they and many other plastic surgeons have found that injecting Restylane Silk® with cannulas is safer and causes less bruising because the dull cannula tip is less likely to enter or cut small blood vessels.

Though rare, there are reported cases of blindness while injecting fillers around the eyes. These cases of blindness were thought to be caused by the injection of filler inside the lumen of an artery under high enough pressure that the filler material “backed up” into the arterial tree behind the eye – then with the next heartbeat, the filler was pushed forward into the artery that supplies the retina, blocking it and subsequently causing a “stroke” of the retina. Since this is a very serious concern, Drs. Butler, Patterson & Leveque do many things when injecting around the eye to further reduce the risk of this rare complication. Some of these preventive measures include: understanding the vascular anatomy of the face, using blunt cannulas which are less likely to enter vessels, injecting very slowly using low pressures, and injecting a small amount of epinephrine before the procedure to cause the blood vessels in the area to temporarily constrict (clamp down), and applying ice to the area prior to injecting filler which also causes the blood vessels in the area to temporarily constrict (clamp down).