The Most Dangerous Ground in Aesthetic Medicine
If I were to point to the single most perilous territory you can enter with a needle, it would be anywhere near the brain or the eye. Consider the supratrochlear artery: it emerges from the back of the eye, connects directly to the ophthalmic artery and then to the brain. Blocking that artery is catastrophic—and deep injections on the bone in that region are most likely to do it. Just next to it runs the supraorbital artery, emerging from the same place. It carries the same risks, though it is a smaller vessel. Deep injections on the bone there are the most dangerous you can make.
The Lateral Corrugator and the Risk of Ptosis
Another critical zone of depth is when treating the lateral corrugator. This area is most linked with ptosis—and it all comes down to how deep you go. To understand the muscle, we need to know that it runs from the periosteum medially to the dermis laterally. If you inject at the right level, you are safe. But go underneath the muscle, and the eye becomes vulnerable. Let me show you what lies beneath. Underneath the orbicularis oculi, we are perilously close to the orbital rim, the tiny foramina, and the eye itself. Pushing the needle too deep can lead to eyelid ptosis and a superior rectus palsy