Original Article

The AESTHETICS 2020; 1(1): 1-7

Published online April 30, 2020

© Korean Association For Laser Dermatology And Trichology

ABCs in the Prevention of Filler-induced Ocular Complications

Won Lee, MD, PhD1 , Hyoung-Jin Moon, MD2, Min-Ho Lee, MD3, Min-Sueng Kim, MD4, Wook Oh, MD5

1Yonsei E1 Plastic Surgery Clinic, Anyang, Korea
2Beup Aesthetic Plastic Surgery Clinic, Seoul, Korea
3Bestop Clinic, Suwon, Korea
4Inee Clinic, Seoul, Korea
5Samsung Feel Clinic, Seoul, Korea

Correspondence to: Won Lee
Yonsei E1 Plastic Surgery Clinic, Anyang 14072, Korea

Received: April 1, 2020; Revised: April 7, 2020; Accepted: April 14, 2020

This is an open access article distributed under the terms of the Creative Commons Attribution Non- Commercial License ( which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background and Objectives
Ocular complications are rare, but tragic, side effects of treatments with hyaluronic acid filler. While several study groups have proposed preventive guidelines for hyaluronic acid filler injections, their basis remains somewhat controversial due to a lack of science evidence thereon. The present study sought to simplify preventive guidelines for the use of hyaluronic acid filler injections in clinical practice and to provide scientific data in support thereof.
Materials and Methods
We reviewed evidence of ocular complications secondary to filler injections reported in the literature and recent publications on methods to prevent them.
For easier memorization and recall during routine clinical practice, we developed a set of guidelines organized as an acrostic list of ABCs. The guidelines cover the following aspects of filler injections: An) anatomy (doppler ultrasound), As) aspiration with proper technique, B) big cannulas, C) compression, D) direction of injection, E) epinephrine, F) filler technique for augmentation or wrinkle correction, G) gentle injection of a small amount, and H) history of prior operations or injections.
Clinicians ought to consider the ABCs of hyaluronic acid filler injections for the prevention of ocular complications.

Keywords: Hyaluronic acid filler, Blindness, Prevention, Filler complications, Soft tissue filler