She has been open about her beauty secrets, favorite products, and yes cosmetic treatments. Lilly is no stranger to different cosmetic procedures and surgeries. She’s openly shown her journey about everything from lip fillers to her ruptured breast implant — and a few days ago, another one of those procedures went terribly wrong. 

She posted Monday, October 4, 2021, on her Instagram stories about how she went in for under eye filler, but hours later her face was changing color.

“I’m going to share something pretty scary guys,” she said.

The under eye area is visibly darker, and almost looks like a hematoma- bleeding or bruising under the skin. Unfortunately, this is something much worse, which Lilly took photos of and posted.

This is tissue damage and death characteristic of vascular occlusion; a blood vessel being blocked by filler.

This is dangerous as it can not only lead to tissue death, but can travel through the vasculature in the face and lead to blindness, further infection, or even death.

Dr. Heidi is a board-certified dermatologist and a pediatric dermatologist. She regularly helps children with their skin conditions as well as helping their mothers to look and feel their best. 

She explains the risks of getting filler and how she considers filler treatments as one of the most dangerous procedures we do in cosmetic dermatology.

She discusses  the difference between expected bruising versus signs of dangerous vascular compromise/occlusion:

“Vascular occlusion or compromise can present on a spectrum anywhere from a dull ache to extreme pain. Its appearance near the injection site can feature geographic discoloration, gray, white, or black discoloration. It can also present as skin that is cold or clammy to touch.”

You can find Dr. Heidi on her Instagram and via her website.

Although Lilly was able to get rushed to the UCLA medical center and work on reversing the damage, not everyone is as lucky. And these filler complications are more common than many people realize.

Filler is normally made from hyaluronic acid. There are many different kinds, but usually this is injected by a licensed practitioner with a needle or a cannula underneath the skin.

It is common to have lip filler, cheek filler, and yes, under eye filler like Lilly opted for. Many people want under eye filler to help with dark circles, shadows, and to prevent aging in the face. As we grow older, our bone structure changes, and collagen and elastin can break down, this combined with gravity can cause the skin under the eyes to sag. 

Occasionally, fat pockets under the eyes can herniate out leading to a look of eye bags and tiredness. While fillers aren’t always the best solution, they can work for something. Filling in some of the deeper pockets in the orbit, the eye area, can help to make this area look more even, less shadowed, and therefore help with the look of under eye circles and darkness. 

It is a relatively routine treatment, but it can go very wrong, especially because it is not always performed by licensed doctors, dermatologists, or ophthalmologists, who are experts when it comes to the skin and eyes.

Many medical spas are known to legally perform an injector filler, but unfortunately many of these locations do not know what to do when something goes wrong.

Seeing as we have a complex network of blood vessels and vasculature all throughout our face, even in the most experienced hands, it is possible for some of this filler to occlude or block a blood vessel.

When this happens, circulation stops. Circulation brings oxygen and blood to the area. Without this, tissue can die very quickly, and start to necrose.

The best and first treatment and protocol for this is an injection of hyaluronidase —this is an enzyme that breaks down hyaluronic acid that dermatologist, doctors, plastic surgeons, and emergency medical staff have on hand.

Unfortunately, many medical spas and locations that perform fillers don’t always have the right medication, the licenses to administer them, or know what to do when something goes wrong.

In extreme cases, blood vessels can be flushed, and other measures can be used to prevent blindness and tissue death.

Thankfully, Lilly’s condition was recognized and diagnosed quickly, and she was able to get the care that she needed to reverse long lasting damage.

She bravely shared the story of what she has gone through as a message to others to make sure that you are seeing a licensed practitioner, and are monitoring side effects in case something goes wrong.

Even in the hands of the world's top dermatologists and plastic surgeons, things can happen. Even with the most trained injector, there is always a risk of vascular occlusion, which is why it is important to always stay alert while undergoing, or performing cosmetic procedures.

Under eye fillers are nothing new, and they are definitely not going away. The media and the industry constantly has us searching for the next best anti-aging tool or trick. 

While Lilly also posted to her stories explaining that although this experience was scary and traumatic, she’s not yet ready to give up fillers. She understands that complications can happen, and that there are risks —and she speaks openly about how the pressure from being in the media and the industry sometimes overwhelms the fear that can come along with complications.

However this is something we don’t often see from celebrities. When things go wrong and procedures happen, they often happen behind the scenes. Lilly’s bravery and sharing her story is a note that this can happen to anyone, and serves as a reminder to us to make sure that we are seeing the right practitioners, to make sure that we have a back up plan, a healthy level of skepticism, and to always remain prepared and aware. 

I am personally grateful that Lilly has been so open about this experience. She has been open about this before on her personal blog, writing, “And, for anyone that has something negative to say about fillers or lasers (or plastic surgery for that matter) - this is my body, my life, and it’s therefore my decision 🙂 You do with yours as you please, and I’ll do the same. It’s no one’s place to judge someone else for such a trivial thing.”

Remember that every treatment and every procedure comes with risks, but we can do our best to mitigate those by preparing, speaking with experts, and trusting those that have knowledge, education, and practice to keep us safe. And the experience of knowing what to do when things go wrong.

Have you ever had filler? Would you ever consider it? Or, do you know of anyone who has had complications? I would love to learn more about your story if you, like Lilly, are open and willing to share!