From The Straits Times    |

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The Straits Times reported recently that a woman went blind in July after being administered a dermal filler, in what is believed to be the first such incident here.

Parvus – the Singapore distributor of AestheFill, the dermal filler involved in the incident – told ST that its investigation found the complication was caused by blood vessel blockage during the procedure.

Meanwhile, the Ministry of Health (MOH) said on Friday it was conducting its own investigations into the case.

But what are dermal fillers, and what are the risks associated with such implants? ST asks the experts.

What are dermal fillers? 

“Dermal fillers are cosmetic products that are injected into the skin to add volume, fill in wrinkles, and enhance various facial features,” said Dr Low Chai Ling, founder of SW1 Clinic, which offers aesthetic services.

Procedures involving dermal fillers are quite common, she said, noting they are used for purposes such as reducing the appearance of lines and wrinkles, augmenting lip volume, and sculpting and reshaping facial contours such as the jawline and chin. 

What are the risks associated with dermal fillers?

Dermal fillers are generally considered safe when administered by trained and experienced medical professionals, though they come with potential risks and side effects, as with any other medical procedure.

The prospect of encountering such risks depends on factors such as the type of filler used, the skill of the practitioner, and individual patient characteristics, said Dr Low.

Risks can include bruising and swelling, allergic reactions and, in rare cases, tissue damage, she added. 

However, risk is generally low when procedures are performed by experienced medical practitioners who follow safety guidelines.

“Patients can further reduce their risk by choosing qualified professionals, discussing their medical history and expectations thoroughly, and following post-procedure care instructions,” said Dr Low. 

Dr Tan Ying Zhou, the founder and medical director of Mizu Aesthetic Clinic, said on ST’s online video show To The Point that such risks were more common in illegal procedures conducted by unlicensed individuals. 

How likely is someone to experience blindness as a result of a procedure involving dermal fillers? 

SW1’s Dr Low noted that the filler AestheFill is a Poly-L-lactic acid (PLLA) biostimulatory filler, which stimulates collagen production in the skin over time.

Arterial occlusion – where blood flow through an artery is blocked – can occur if PLLA is inadvertently injected into a blood vessel. 

Blindness following filler injection into the nasolabial lines – which extend from the nose to the corners of the mouth, and are also known as laugh lines – can occur due to a rare complication known as retinal artery occlusion. 

This can happen if the filler is inadvertently introduced into a nearby blood vessel, she explained.  

The filler material can travel through blood vessels, eventually reaching the ophthalmic artery, which supplies blood to the retina, the innermost tissue layer of the eye which processes images. 

AestheFill, the filler that was involved in the case, is a Poly-L-lactic acid (PLLA) biostimulatory filler, which stimulates collagen production in the skin over time. PHOTO: REGEN BIOTECH

“Once the filler obstructs the retinal artery or its branches, it can lead to a sudden and severe reduction in blood flow to the retina,” said Dr Low. 

“This results in a condition called retinal artery occlusion which, if not promptly addressed, can cause permanent damage to the retina and result in vision loss, including blindness.”

She added that preventing this complication involves a thorough knowledge of facial anatomy, precise injection techniques, and awareness of the potential risks associated with filler procedures.

What should someone who is considering getting dermal fillers or undergoing other aesthetic procedures here consider before proceeding?

Things to look out for include the type and brand of fillers offered, as well as the doctor’s medical credentials and level of experience, said Mizu’s Dr Tan.

Those interested should also go to certified medical clinics rather than opt for illegal procedures offered by unlicensed individuals, he added.

Dr Low said people should also be honest about their medical history, including factors such as allergies, previous cosmetic procedures and underlying health conditions. 

“Certain medical conditions or medications may affect your eligibility for treatments,” she noted.

In addition, patients should be well-informed about the potential risks and side effects associated with their chosen procedure.

For example, they should understand how skin type may influence potential risks and side effects, such as pigmentation changes during laser treatments.

“Taking the time to consider these factors and having open and honest communication with your chosen practitioner is key to making informed decisions about aesthetic procedures and ensuring a safe and satisfying experience,” she added.

This article was first published in The Straits Times.