Retrospective Review of Superficial Serial Microdroplet Technique for Glabellar Filler

BACKGROUND Injecting fillers in the glabella is dangerous due to numerous arterial vessels connecting to the ophthalmic artery putting patients at risk for skin necrosis and blindness. OBJECTIVE Analyze the incidence of side effects with a superficial microdroplet glabellar injection technique. MATERIALS AND METHODS A retrospective review was done in a private practice of one board-certified dermatologist's patients' charts utilizing a superficial serial microdroplet technique with a 30-gauge needle to treat etched glabellar rhytides from 2013 to 2023. RESULTS The review identified 719 glabellar injections performed on 23 men and 696 women with an average age of 69. There were reports of mild bruising, swelling, and bumps, all resolving within 2 weeks. There were no serious complications such as infection, vascular occlusions, or granulomas and no long-term or delayed onset complications reported. There was one case of a glabellar vascular occlusion referred to the author for treatment during the review period by an injector trained in this technique. CONCLUSION Injecting filler in the glabella is high risk, with the possibility of causing skin necrosis and blindness. Even with a safer microdroplet technique, most injectors should avoid this area, and advanced injectors planning this treatment should have knowledge of the anatomy and an understanding of techniques to decrease the risk.