Injecting soft tissue fillers in the perioral and periorbital muscle layers increases the risks of vascular occlusion, delayed nodules and inflammation, according to a literature review by Greg J. Goodman, MD, et al, published the Journal of Cosmetic Dermatology (online June 5, 2020).
The researchers searched Pubmed, Ovid and Google Scholar for papers on intramuscular injections, filler, filler reactions and combinations and variations of these terms in order to study the role of injections in or around this layer in the production of significant adverse reactions. They found that injection into mimetic musculature of the face, especially the musculature in the periorbital and perioral regions, is prone to adverse reactions. These include: vascular issues due to the abundant blood supply and vascular connections of periorificial muscles; displacement of filler due to the mechanical effects of the muscles; and inflammatory responses also related to the inherent activity and supporting vasculature surrounding or following the muscles.
They recommend injecting superficially or below the muscle layer (where appropriate) in order to reduce the risks of vascular occlusion, product clumping or displacement, tendency to late nodularity and swelling.
Read to full study here.