BACKGROUND Tissue fillers are generally safe and well tolerated by patients . However, complications do occur and may be very severe, such as intravascular injection (with occasional residual tissue loss, visual and neurological sequelae) and late nodularity and swelling . Methods to lessen the likelihood of complications have been the subject of much recent literature . Depth of injection has been identified as a key safety consideration . PATIENTS/
METHODS The role of injection of facial filler into the muscular layer of the face is explored in this article . Literature was explored using available search facilities to study the role of injections in or around this layer in the production of significant adverse reactions .
RESULTS A body of literature seems to suggest that injection into mimetic musculature of the face especially the musculature in the periorbital and perioral regions is prone to adverse reactions .
CONCLUSIONS Injection of agents into the perioral and periorbital mimetic muscular layer may produce, product clumping, displacement, and tendency to late nodularity and swelling . It also risks intravascular injection as compared to injection of other layers of the face . Injection into the mimetic muscles especially the sphincteric muscles should be avoided to minimize the risk of complications.
MeSH: Cosmetic Techniques, adverse effects, Dermal Fillers, administration & dosage, adverse effects, Edema, etiology, prevention & control, Face, Facial Muscles, blood supply, Humans, Injections, Subcutaneous, adverse effects, methods