Volumetric rejuvenation of the face with fillers has gained popularity as being the least invasive intervention whose adverse effects are mostly minor, short-lived and self-limited.1 However, this is not always the case.
An 83-year-old woman who had a longstanding history of diabetes, hypertension and myocardial infarction was admitted after fainting. Her vital signs, initial examination, laboratory tests and ECG were unremarkable. However, head CT yielded a surprising incidental and asymptomatic finding (figure 1). She was discharged 1 day later with a diagnosis of syncope due to orthostatic hypotension due to diabetic autonomic neuropathy.
Cheek augmentation is usually done either by surgical placement of solid implants (commonly silicone) or much more often by injections using hyaluronic acid—currently, the most widely used filler; or autologous fat; collagen; calcium hydroxylapatite; etc. The goal is to achieve aesthetic enhancement by adding volume to areas that had recessed with age.
Head CT is very...
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