Cerebral Embolism as a Result of Facial Filler Injections: A Literature Review

Facial filler injections are widely used in aesthetic dermatology and plastic surgery for rejuvenation and volume restoration. Despite their popularity and generally favorable safety profile, rare but severe complications, including cerebral embolism, have emerged in the literature. This review aims to explore the existing evidence surrounding cerebral embolism resulting from facial filler injections, with a focus on incidence, anatomical risk factors, pathophysiological mechanisms, clinical manifestations, diagnostic challenges, management strategies, and outcomes. An extensive literature search was conducted using PubMed, Scopus, Embase, and Web of Science for studies published from 2015 to 2024. A total of 37 cases were identified, with the glabella, nasal dorsum, and forehead being the most common sites associated with complications. The pathogenesis involves retrograde arterial embolization with filler materials entering cerebral circulation via branches of the ophthalmic artery. Common clinical signs include sudden vision loss, headache, hemiplegia, aphasia, and altered consciousness. Prompt recognition and early management are crucial but often fail to reverse neurological deficits. Preventive strategies, such as anatomical knowledge, appropriate injection technique, and use of blunt cannulas, are essential. This review highlights the need for greater awareness among practitioners and recommends standardized emergency protocols to reduce the burden of these rare but catastrophic events.