Grants Funded
ASPS/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.
Research Abstracts
Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area or PSF funding mechanism.
FACIAL: Characterizing Filler Associated Changes in Infraorbital Area Lymphatics
Principal Investigator
Samuel Lin MD
Samuel Lin MD
Year
2025
2025
Institution
Beth Israel Deaconess Medical Center
Beth Israel Deaconess Medical Center
Funding Mechanism
Aesthetic Plastic Surgery Research Grant
Aesthetic Plastic Surgery Research Grant
Focus Area
Cosmetic, Cranio/Maxillofacial/Head and Neck
Cosmetic, Cranio/Maxillofacial/Head and Neck
Abstract
Project Summary
Hyaluronic acid (HA) dermal fillers are among the most popular cosmetic treatments worldwide, used to restore volume to areas such as the under-eye region (infraorbital area) and address facial wrinkles. However, there is increasing concern about adverse effects that occur after HA filler injections, particularly chronic swelling (malar edema), persistent infraorbital and lower eyelid swelling, and other complications, such as contour irregularities and skin discoloration. These issues are difficult to treat and may require surgical intervention. The causes behind these complications are poorly understood, and limited research focuses on the infraorbital area.
This study explores the role of the facial lymphatic system in the development of adverse effects secondary to HA filler injection. The lymphatic system is critical for fluid balance and waste removal in the body. We hypothesize that filler disturbs lymphatic function to cause chronic swelling and discoloration under the eye.
The primary goals of this study are to (1) better understand how HA fillers impact lymphatic flow in the infraorbital region and (2) assess the nature of complications following HA filler injections. Using Indocyanine Green (ICG) dye, we will map lymphatic drainage patterns before and after HA filler injections in healthy adults for 6 months. We will additionally examine a smaller cohort of patients with history of under-eye filler and associated periorbital edema at a single timepoint. We will document clinical outcomes, including adverse effects like swelling, bruising, and the "Tyndall effect" (blue discoloration), which are common to infraorbital HA injections.
The study's findings will elucidate the mechanisms behind filler-related periorbital complications, particularly with respect to lymphatic disruption. By understanding these mechanisms, we can optimize patient selection, enhance safety protocols, and refine treatment strategies to prevent these adverse effects, ultimately improving the long-term aesthetic outcomes for patients. Through this investigative approach, we aim to establish proof-of-concept for lymphatic obstruction as a key factor in filler-related
complications and contribute to a deeper understanding of facial lymphatics, an area of study that remains underexplored. This research could significantly impact clinical practices and guidelines for aesthetic procedures, ensuring safer outcomes and minimizing the need for corrective surgeries.
Impact Statement
Hyaluronic acid (HA) dermal fillers are widely used for aesthetic treatments, but complications such as chronic under-eye swelling (malar edema) are underreported and poorly understood. These issues are often difficult to treat and may require surgery. This study will explore how HA fillers disrupt lymphatic drainage in the infraorbital region, potentially causing swelling and other adverse
effects. By investigating this mechanism, we aim to improve patient safety, optimize treatment strategies, and reduce the need for corrective procedures, ultimately enhancing long-term outcomes for filler patients.
Project Summary
Hyaluronic acid (HA) dermal fillers are among the most popular cosmetic treatments worldwide, used to restore volume to areas such as the under-eye region (infraorbital area) and address facial wrinkles. However, there is increasing concern about adverse effects that occur after HA filler injections, particularly chronic swelling (malar edema), persistent infraorbital and lower eyelid swelling, and other complications, such as contour irregularities and skin discoloration. These issues are difficult to treat and may require surgical intervention. The causes behind these complications are poorly understood, and limited research focuses on the infraorbital area.
This study explores the role of the facial lymphatic system in the development of adverse effects secondary to HA filler injection. The lymphatic system is critical for fluid balance and waste removal in the body. We hypothesize that filler disturbs lymphatic function to cause chronic swelling and discoloration under the eye.
The primary goals of this study are to (1) better understand how HA fillers impact lymphatic flow in the infraorbital region and (2) assess the nature of complications following HA filler injections. Using Indocyanine Green (ICG) dye, we will map lymphatic drainage patterns before and after HA filler injections in healthy adults for 6 months. We will additionally examine a smaller cohort of patients with history of under-eye filler and associated periorbital edema at a single timepoint. We will document clinical outcomes, including adverse effects like swelling, bruising, and the "Tyndall effect" (blue discoloration), which are common to infraorbital HA injections.
The study's findings will elucidate the mechanisms behind filler-related periorbital complications, particularly with respect to lymphatic disruption. By understanding these mechanisms, we can optimize patient selection, enhance safety protocols, and refine treatment strategies to prevent these adverse effects, ultimately improving the long-term aesthetic outcomes for patients. Through this investigative approach, we aim to establish proof-of-concept for lymphatic obstruction as a key factor in filler-related
complications and contribute to a deeper understanding of facial lymphatics, an area of study that remains underexplored. This research could significantly impact clinical practices and guidelines for aesthetic procedures, ensuring safer outcomes and minimizing the need for corrective surgeries.
Impact Statement
Hyaluronic acid (HA) dermal fillers are widely used for aesthetic treatments, but complications such as chronic under-eye swelling (malar edema) are underreported and poorly understood. These issues are often difficult to treat and may require surgery. This study will explore how HA fillers disrupt lymphatic drainage in the infraorbital region, potentially causing swelling and other adverse
effects. By investigating this mechanism, we aim to improve patient safety, optimize treatment strategies, and reduce the need for corrective procedures, ultimately enhancing long-term outcomes for filler patients.
Biography
Samuel J. Lin, MD, MBA, FACS is the program director for the BIDMC/Harvard Plastic Surgery Residency Training Programs, Co-Director for the Harvard Aesthetic and Reconstructive Fellowship Program at BIDMC, and Director of Aesthetic Surgery at BIDMC. Dr. Lin received his Bachelor's degree in Biomedical Engineering from Northwestern University and his MD from Northwestern University Feinberg School of Medicine. He completed his residency in Otolaryngology-Head and Neck Surgery at Northwestern Memorial Hospital, followed by a residency in Plastic and Reconstructive Surgery and microvascular fellowship at M.D. Anderson Cancer Center. Dr. Lin is a member of the American Society of Plastic Surgeons, American Board of Plastic Surgery, and American Association of Plastic Surgeons, as well as a fellow of the American College of Surgeons.
Samuel J. Lin, MD, MBA, FACS is the program director for the BIDMC/Harvard Plastic Surgery Residency Training Programs, Co-Director for the Harvard Aesthetic and Reconstructive Fellowship Program at BIDMC, and Director of Aesthetic Surgery at BIDMC. Dr. Lin received his Bachelor's degree in Biomedical Engineering from Northwestern University and his MD from Northwestern University Feinberg School of Medicine. He completed his residency in Otolaryngology-Head and Neck Surgery at Northwestern Memorial Hospital, followed by a residency in Plastic and Reconstructive Surgery and microvascular fellowship at M.D. Anderson Cancer Center. Dr. Lin is a member of the American Society of Plastic Surgeons, American Board of Plastic Surgery, and American Association of Plastic Surgeons, as well as a fellow of the American College of Surgeons.