Management of blindness in the practice of cosmetic surgery

Blindness (amaurosis) as a complication of cosmetic surgery is not common, but has been reported in cases of blepharoplasty, as well as in connection with facial injection of various substances, including collagen. The anatomic and pathophysiologic basis for embolization of the retinal artery is presented, and the literature regarding thromboembolic, spasmodic, and vaso-obliterative etiologic factors in amaurosis is reviewed. It is recommended that ocular examination be carried out prior to both injection of materials into the face and blepharoplasty. The treatment of this most serious complication is reviewed in detail. Finally, it is suggested that the surgeons who practice cosmetic surgery be aware of this complication and the current treatment modalities.