Q: Dr. Eppley, I had an extremely pronounced (Stage 4 I think) single glabellar line that was treated with Juvaderm and Botox multiple times back in 2007/2008. The single line is now gone but significant 11 lines that have formed around it. My current dermatologist has a concern with fillers and the glabellar region due to the blindness risk. Do you do Acellular Dermal Matrix Insertion? Is that a viable option? Is it an expensive procedure? What are my options for glabellar implants?
A: I have placed about every conceivable graft material into glabellar lines. Acellular dermal matrix (ADM) is just one example and there are many other options including synthetic implants. The most common form of ADM would be Alloderm, which is an allogeneic cadaveric dermal product which has been around for years. It is placed in the office as a simple office procedure done under local anesthesia. But other implant types, such as synthetic Permalip implants can be used, which has a guaranteed volume retention. And are just as easily placed as any other glabellar graft or implant material.
While blindness is an extremely rare complication from the use of injectable fillers around the eyes, the way to completely negate that concern is a non-injectable implant placement.
Dr. Barry Eppley