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Bilateral Hemifacial Spasm After Filler Injection.
Alyson Kishi1, Celestine H Gregerson2,3, Cameron Yang2,3
1The Ohio State University College of Medicine.
Ophthalmic Plastic and Reconstructive Surgery
|June 9, 2025
Summary
A patient developed hemifacial spasms after poly-L-lactic acid (PLLA) filler injections. This case suggests a potential link between PLLA fillers and facial nerve compression, leading to spasms.
Area of Science:
- Neurology
- Dermatology
- Ophthalmology
Background:
- Facial nerve disorders can manifest as hemifacial spasms.
- Dermal fillers, including poly-L-lactic acid (PLLA), are widely used for cosmetic enhancement.
- Complications from dermal fillers, though rare, can involve neurological sequelae.
Purpose of the Study:
- To report the first case of bilateral hemifacial spasm potentially associated with poly-L-lactic acid (PLLA) dermal filler injections.
- To investigate the relationship between PLLA filler placement and facial nerve irritation.
Main Methods:
- A case study of a 57-year-old woman presenting with hemifacial spasms post-PLLA filler.
- Clinical examination including ophthalmology assessment.
- Magnetic Resonance Imaging (MRI) to visualize filler placement and anatomical relationships.
Main Results:
- The patient experienced left hemifacial spasm 1-2 weeks after PLLA injections to the temples and cheeks.
- MRI confirmed subcutaneous PLLA filler adjacent to the temporal and zygomatic facial nerve branches.
- Spasms improved with gabapentin, and later developed on the right side, suggesting bilateral involvement.
Conclusions:
- Poly-L-lactic acid (PLLA) filler may cause hemifacial spasms due to compression or irritation of the facial nerve.
- This case highlights a novel potential complication of PLLA dermal fillers.
- Further research is warranted to understand the mechanism and incidence of filler-induced facial nerve complications.
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