CC BY 4.0 · Arch Plast Surg 2023; 50(02): 148-152
DOI: 10.1055/s-0043-1761211
Cosmetic
Case Report

Recovery of Acute Ophthalmoplegia after Hyaluronic Acid Filler Injections to the Temples: A Case Report and Review of the Literature

Fatemeh-sadat Tabatabaei 
1   Students' Scientific Research Center (SRCC), School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
,
Amirali Azimi 
1   Students' Scientific Research Center (SRCC), School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
,
Seyyed Shahabeddin Tabatabaei 
2   Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
Hossein Pakdaman 
3   Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Funding The authors received no financial support for the research, authorship, and/or publication of this article. This research received no specific grant from any funding agency.
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Abstract

Soft tissue filler injection is the second most common nonsurgical cosmetic procedure. Despite the safety of fillers, as use has grown, so has the number of patients affected by adverse events. Ophthalmoplegia following cosmetic filler injection is a rare complication, mostly occurring after injection to the glabella, nasolabial fold, periorbital, and lateral nasal site. In all cases where ophthalmoplegia has been reported following fillers, patients have simultaneously experienced vision loss and other ocular symptoms. We report a case of isolated acute ophthalmoplegia following hyaluronic acid injection solely in the temple region. A 40-year-old woman, 3 hours after the procedure, presented to our hospital with left eye ophthalmoplegia, ptosis, and hypotropia. Treatment started with hyaluronidase, steroids, and anticoagulants. After 4 weeks, left eye ophthalmoplegia remained unchanged, and through a 10-week follow-up, all left ocular movements improved, and only mild hypotropia and ptosis persisted. This case report shows that ophthalmoplegia may also happen with temple region filler injections. We also review available prevention techniques and treatments to avoid such complications when performing soft tissue fillers for gaunt appearance correction.

Keywords

ophthalmoplegia - surgery - plastic - hyaluronic acid - cosmetics

Author Contributions

Data curation: S.S.T. Methodology: S.S.T., A.A., F.T. Visualization: S.S.T., H.P. Writing—original draft: A.A., F.T. Writing—review, and editing: F.T., A.A. Project administration: S.S.T., H.P. Investigation: A.A., F.T. Supervision: S.S.T., H.P.


Ethical Approval

This report was conducted in accordance with the Declaration of Helsinki.


Patient Consent

Informed consent was obtained before collection of images, including permission for publication of all photograph and images included herein.




Publication History

Received: 23 June 2022

Accepted: 24 November 2022

Article published online:
28 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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