@pa_nicola: One of the questions I ask myself before offering any treatment is whether the potential benefit justifies the potential risk. That calculation is different for every procedure, every patient, and every provider. For me, filler in the glabella and nose falls on the side of procedures I have chosen not to perform. While excellent outcomes are certainly possible, these areas also carry the highest risk of filler-related visual loss. A 2024 systematic review by Doyon et al. identified 365 new reported cases of filler-associated visual loss, with the nose accounting for 40.6% of cases and the glabella for 19.0%. After many conversations with mentors I deeply respect and years of studying anatomy and complication management, I made the decision that those procedures are simply not part of my practice. That doesn’t mean every provider will make the same decision. It does mean I believe patients deserve to understand the true risks before deciding whether a treatment is right for them. Medicine has always been about balancing risk and benefit. In aesthetics, that conversation should be no different. Sometimes the safest treatment plan is the one you choose not to perform.

Pa_Nicola

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Tuesday 04 August 2026 16:35:45 GMT