 The third most common cosmetic procedures in the US, each done nearly a million times a year, are chemical peals and laser skin resurfacing to create a controlled injury to the face. The reasoning is that the regeneration, repair, and remodeling of the damage can result in a more tightened appearance, but may or may not actually help with wrinkles. The inflammation caused by these types of facials causes edema, fluid retention in the face that, because of the swelling, can cause a transient improvement in the appearance of fine wrinkles, but in the end may do more harm than good. Short-term side effects include bruising, swelling, itching, crusting, redness, infection, acne, and amylia, which are little white cysts. Long-lasting side effects can include persistent redness, pigmentation changes, and scarring. The second most common cosmetic procedure after Botox is volumizing injections of soft tissue fillers carried out about 3 million times a year in the US alone. Studies show subjective patient satisfaction is often high. The long-term efficacy data are lacking because people tend to undergo subsequent procedures. Adverse outcomes occur in about 1 in 40 procedures, most commonly bruising, discoloration, or unsightly lumps and bumps. Lumps are the most frequently reported adverse event reported to the FDA followed by infection. It's important to not apply makeup or otherwise touch the injection sites for at least four hours to prevent introducing bacteria into the needle tracks. The most devastating filler complication is permanent blindness, due to an accidental injection into an artery, which can cause skin necrosis, but most seriously can cause an embolus that lodges into the ophthalmic artery and cuts off blood flow to your retina. This is exceedingly rare on the order of 1 in 1,000 nose injections, for example, and in nearly all the cases, the vision loss was only in one eye. There are some factors that mediate the blindness risk. Autologous fat injections, when they inject your own liposuction fat, seem to be the riskiest since they use a larger volume in needle. Though other facial injections, including platelet-rich plasma, have also resulted in irreversible vision loss. To prevent this, medical personnel are always taught to aspirate a bit first, pull the plunger on the syringe back to look for that red flash of blood that would indicate you're in an artery. Unfortunately, this can give a false sense of security as tiny movements of the needle can change its position. The highest risk area is the globular region, the skin between the eyebrows and over the nose. Unfortunately, there does not appear to be a safe zone since there's a rich web of connections among arteries throughout the face. Though blindness from filler injections has been said to occur in any location on the face, there does not appear to be any cases arising solely from lip augmentation. Like with Botox, these days a large fraction of filler injections are done by non-healthcare professionals in a medical spa type setting. This raises concerns about illegal, non-FDA approved fillers. There are reports of injections with everything from rubber cement to fixaflat, resulting in disfigurement and even death.