Forehead Filler Complications: Nerve Sensitivity and Risks

Forehead augmentation results in a prominent vein that may cause tingling in the scalp (using Water Microcrystal and Ellanse)?

Hello! I would like to inquire if this situation is urgent! Recently, after receiving forehead fillers (water microcrystals, Ellanse), I have developed a tingling sensation in the scalp at the injection site, a depression above the eyebrows (the doctor is an ENT specialist and tends to inject within the eyebrow area and slightly above, resulting in a very pronounced effect), and I have undergone three treatments in the glabella area.
After the third treatment, I experienced a tingling and prickling sensation.
Is this tingling sensation urgent? I checked the facial vascular anatomy online, and it seems to resemble the supratrochlear artery, vein, and trochlear nerve, as the doctor tends to inject lower (starting within the eyebrow and moving upwards, also injecting at the glabella, which makes it appear more masculine, not suitable for women).
Could this cause chronic damage? I'm concerned about potential complications like blindness, facial paralysis, or vascular embolism.
I hope to find a doctor who can truly help.
I have looked into several major hospitals but am unsure which department to visit or which doctor to consult.
Would it be appropriate to see a plastic surgeon who specializes in facial nerve paralysis? I hope to receive assistance, as I am already feeling overwhelmed!
This is how I feel when I touch the area: in the middle of the right eyebrow, there is a connection that resembles the supratrochlear artery, vein, and trochlear artery.
When I lightly touch the most prominent area of the filler, I feel a tingling sensation that extends to the top of my head, and when I frown or close my eyes tightly, the right side of my forehead and scalp feel even more numb.
I have consistently felt a tingling sensation in the top of my head and the right side of my face.
There is a tightness in a vein connected to my head, causing numbness.
The left side of my forehead feels prickly.
I really don’t know what to do; the aesthetic clinic said not to worry, attributing it to the anesthetic?! Is that really the case? I have never experienced this before.
I came across an article (What to do if cosmetic procedures with sharp needles can cause blindness, blunt needles are safer?) and I am afraid that it might damage the nerves leading to chronic stroke or blindness, as my scalp feels numb.
The doctor’s injections are very pronounced, and I feel tightness in my forehead.
Before reading the article, I was already concerned that the filler might be too compressed, causing excessive pressure that could obstruct blood vessels, leading to blood flow issues, and causing the vessels to dilate, similar to how prolonged sitting can compress nerves and lead to numbness.
Over time, surrounding tissues could suffer from ischemia and necrosis.
I am very worried because the material used for the injections may calcify, leading to fibrosis, making it difficult to change the texture, and causing ongoing nerve compression over time.

Niming, 30~39 year old female. Ask Date: 2023/12/26

Dr. Zhou Hongzhang reply Plastic Surgery

1.
It is likely an inflammatory reaction caused by the medication (water microcrystals, Ilanes) that is irritating the supraorbital nerve, resulting in a tingling sensation in the scalp.

2.
This nerve (supraorbital nerve) is a sensory nerve and will not cause motor impairment.

3.
If the medication has entered an artery, symptoms may occur within 24 hours, such as vision impairment, severe pain, and skin necrosis, among others.

4.
Most of the time, once the effects of the medication wear off, the tingling sensation in the scalp will also improve somewhat.

5.
You can visit a plastic surgery outpatient clinic for further examination or consultation.

Reply Date: 2023/12/26

More Info

When it comes to complications arising from forehead fillers, particularly concerning nerve sensitivity and potential risks, it is essential to approach the situation with caution and a thorough understanding of the anatomy involved. Your concerns about experiencing numbness and tingling sensations in the forehead area following filler injections are valid and warrant careful evaluation.

Firstly, it is important to recognize that the forehead and surrounding areas contain several critical structures, including nerves, blood vessels, and muscles. The most relevant nerves in this context are the frontal branch of the facial nerve and the supraorbital nerve, which can be affected during cosmetic procedures. If filler is injected too deeply or inappropriately, it can lead to nerve compression or irritation, resulting in symptoms such as numbness, tingling, or even pain.

The symptoms you describe—numbness, a tingling sensation, and a feeling of tightness in the forehead—could potentially indicate nerve involvement. While it is common to experience some temporary numbness or swelling after filler injections, persistent or worsening symptoms may suggest a more serious issue, such as vascular occlusion or nerve damage. Vascular occlusion can occur if filler inadvertently enters a blood vessel, leading to compromised blood flow, which can result in tissue ischemia or necrosis if not addressed promptly.

Your mention of the location of the symptoms being near the supratrochlear and supraorbital arteries is particularly concerning. If the filler has migrated or caused pressure on these vessels, it could lead to complications such as skin necrosis or even vision loss in severe cases. The risk of these complications underscores the importance of seeking care from a qualified medical professional who specializes in facial aesthetics.

In terms of urgency, if your symptoms are persistent and causing you significant distress, it is advisable to seek medical attention as soon as possible. You should consider consulting with a board-certified plastic surgeon or a dermatologist with expertise in cosmetic procedures. These specialists can perform a thorough examination, possibly including imaging studies, to assess the situation and determine the best course of action.

Regarding your concerns about chronic damage, it is crucial to understand that while some complications can resolve with time, others may lead to long-term issues if not addressed. Chronic nerve compression can lead to conditions such as neuropathy, which may require more extensive treatment. Additionally, if the filler material is causing ongoing pressure on surrounding tissues, it could potentially lead to fibrosis or other structural changes that may complicate future treatments.

In conclusion, while some degree of numbness or sensitivity can be expected after filler injections, persistent or severe symptoms should not be ignored. It is essential to consult with a qualified medical professional who can provide an accurate diagnosis and appropriate treatment options. Your health and well-being should always be the top priority, and addressing these concerns promptly can help prevent further complications.

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