Recently Dr. Chatsorn Likhit-Isara (Dr. Som) from MUDAN PAVILION WELLNESS CENTER Honored to be part of the show "Women are awesome" On Channel 3 (press 33) in the "Talk with the Doctor" segment, there will be a discussion on a topic that many people are very interested in, the news of "injecting collagen stimulants that cause blindness". This event also has three very hot hosts. Ms. Pat Napapa Tantrakul, Ms. Boom Supaporn Wongthuaythong, and Ms. Por Punyawir Sukkulworaset Join us for a fun and friendly program and give Dr. Som a chance to answer questions about safe collagen injections.
Follow special content and advice from Dr. Som here!
What are collagen stimulants?
Collagen stimulants are substances that contain ingredients that help stimulate the body to produce more collagen naturally. Collagen is an important protein in the skin that helps keep the skin firm, elastic, and youthful. The body is made up of 5 types of collagen: Type I, II, III, IV, V.
The most common collagen found on the face is Collagen Type I and Collagen Type III.
- Collagen Type I: Helps tighten skin
- Collagen Type III: Helps skin elasticity
These two work together to give your skin a youthful appearance.
Collagen is made by combining several amino acids (the body uses these amino acids from the proteins we eat) + vitamins and minerals → forming pre-collagen protein chains → converted to type I collagen in skin cells and connective tissue.
What does collagen stimulant help with?
Helps skin to be firm, elastic and look younger. Currently, there are many brands in Thailand such as:
- Collagen stimulant CaHA: Calcium Hydroxylapatite is calcium that can be obtained by grinding tuna bones into a fine powder.
- Collagen stimulant PLLA: It is one of the first collagen stimulants to be approved and approved by the FDA. PLLA collagen stimulant is a polymer material that is safe for the human body because it is a substance synthesized from plants and is the same innovation as medical sutures.
Collagen stimulant PDLLA: It is a polymer extracted from nature and is a substance with the same molecule as Poly Lactic Acid (PLA). It has different properties from PLA, namely, it has a surface area that is related to the body's collagen stimulation process. PDLLA can be decomposed by natural processes. In medicine, PDLLA has also been developed as a drug delivery agent to the desired area.
What causes collagen stimulant injections to cause blindness?
From the case study that was in the news, it was found that collagen stimulating substances were injected. PDLLA Which is a group of substances Polymers And then blindness occurs. It was found that the main cause is from Blood clot It can be divided into 3 important issues as follows:
- Selection of inappropriate substances : Collagen stimulants used for injection in such cases Not designed for injection around the eye socket. This is a point with important blood vessels. If injected incorrectly or in an inappropriate location, the substance may enter the blood vessels and lead to blockage.
- Blockage due to sediment : In cases where collagen stimulating substances in the polymer group are injected and blood vessels become blocked, this is usually due to sediment from the substance that was not shaken or mixed with water well enough, causing sediment to form or not completely dissolve. This case is different from injections. Filler or fat That often causes blockage Along the veins From outside to Ophthalmic Artery and Central Retinal Artery Resulting in severe symptoms such as: Drooping eyelid, swelling, inflammation, eye muscle paralysis And may cause a condition Skin Necrosis If there is a lack of blood flow to the skin
However, in the case of the young designer who was in the news There are no other abnormal symptoms. In addition to immediate blindness after injection, because it is Localized obstruction Make the outside look normal, unlike filler or fat cases where the symptoms are more obvious. - Expertise of the injection doctor : The expertise and knowledge of physiotherapy of the treating doctor. Injecting with an expert will reduce the risk better. If injected with a fake doctor or quack doctor, it may be even riskier and more dangerous than before.
Is using fakes the cause of blindness?
It's not related. Because no matter what substance is injected into the face, it should not enter the bloodstream. The fake ones are even worse. For example, the hyaluronic aid (HA) compound, if an accident occurs, the doctor who injects it can immediately diagnose it because there is still a drug that can dissolve it and provide immediate treatment. But if it is a fake, it is even worse because it cannot be dissolved.
Which positions are at risk of blindness?
The development of postoperative blindnessCosmetic proceduresIt can happen if the product or substance injected into the body enters the blood vessel that is directly connected to the blood vessel that supplies the eye (Ophthalmic Artery), which can lead to the blockage of the blood vessel that supplies the eye. The risk areas are as follows:
- Forehead area It consists of the Supraorbital Artery and the Supratrochlear Artery, which are direct branches of the Ophthalmic Artery. If the substance injected into this vein can spread to the Central Retinal Artery, which may cause occlusion and lead to vision loss.
- Area under the eyes Which has Zygomaticofacial Artery as a branch of Lacrimal Artery and also connects to Ophthalmic Artery. Although smaller than other areas, it has a chance to spread to the blood vessels that nourish the eye.
- Temple area There is a Superficial Temporal Artery which can connect to the frontal branches (Supraorbital and Supratrochlear Arteries). If the injected material spreads along this artery, it may also cause occlusion in the eye.
- The nasolabial fold and cheek areaThere is a Facial Artery which connects to the Angular Artery at the side of the nose and ends at the Dorsal Nasal Artery which is the terminal branch of the Ophthalmic Artery. Most high-risk cases are caused by injection in the nasolabial fold rather than the nose area because Juvelook Volume is not injected in the nose area unless it is used incorrectly.
- Around the eyesOr Periorbital Region is another high risk area. All blood vessels around the eyes are connected to form Vascular Arcades, including Supraorbital Artery, Supratrochlear Artery, Dorsal Nasal Artery, Angular Artery, Infraorbital Artery, Zygomaticofacial Artery, Transverse Facial Artery, Zygomaticotemporal Artery, Zygomaticoorbital Artery, Medial Palpebral Artery and Lateral Palpebral Artery. All of the blood vessels mentioned can carry substances into the Ophthalmic Artery and can affect vision if blocked.
Understanding the location of these blood vessels and their connection to the eye is very important for specialists to take great care in order to reduce the risk of serious complications such as blindness.
How to solve the problem when there is a risk of blindness
Actually, the pitfall that occurred in this case is 1. The patient reported that he could not see. In general, the doctor must stop the procedure immediately, check the pupils, etc. For Golden Hour treatment, the blindness from collagen stimulating injections and filler injections is treated immediately, as soon as possible, and should be within 90 minutes.
Since PDLLA occlusion is more similar to spontaneous CRAO than to filler or autologous fat, for the above reasons, ocular massage may have a role to play, which can be done with caution, to disperse PDLLA clots or other polymer deposits into the peripheral retinal vessels.
Other treatments include reducing intraocular pressure, whether it be taking Diamox, antihypertensive drugs, or even performing paracentesis, which involves puncturing the eye to release the pressure. The reduced intraocular pressure will increase the chance that the blocked clot will spread to the peripheral blood vessels.
And in addition, it is to dilate blood vessels, such as carbon dioxide or bag breathing, and to quickly give oxygen to the retina to receive as much oxygen as possible.
How to inject collagen stimulants without risking blindness
From what Dr. Som said above, the most important thing is to choose an expert doctor because those doctors will know everything from choosing the right products, having a precise understanding of the anatomy, and if an accident occurs, they will be able to solve the problem directly and promptly, and treat or perform procedures with a standard medical facility with a clear license number. For example, if you intend to inject forehead filler, you must choose or consult.A doctor who is good at injecting filler into the forehead Very skilled in this position, etc.
What should you know before deciding to inject collagen stimulants?
First, we must assess the quality of our skin to determine whether we are suitable for treatment with a collagen stimulation injection program. In medicine, there is a tool called the facial assessment score, in which the doctor will examine every layer of the face on the assessment wheel, whether it is the bone layer, deep fat layer, muscle layer, and upper skin layer, which patients can assess and do a preliminary examination by themselves. Touch the skin; if the skin is stretched, thin, or loose, it means that we are suitable for treatment with a collagen stimulation program.
The results after the procedure are not seen immediately. The results of collagen stimulation injections are seen at 4-6 months Because if you are going to an event or have an important day, you may need to plan at least a little in advance. 2 months And it is a procedure that must be done by a specialist doctor only. Because if the injection is wrong, injected in the wrong layer, the result may make the skin look uneven, or if it is serious, it may become a case that is in the news. Or some people are not sure which layer of skin needs to be treated for the problem of the facial structure. It is recommended to consult a specialist doctor before treatment.
