Botox & Dermal Fillers Risks & Aftercare

  /    /    /  Botox & Dermal Fillers Risks & Aftercare



Injection of botulinum toxin causes weakness of targeted muscles, which can last approximately 2-4 months and over this time the effects will diminish. Injection of small amounts of botulinum toxin relaxes the treated muscles and can reduce facial wrinkles such as frown lines. It is injected with a small needle into the targeted muscles. Effects are typically seen in a few days and can take 1-2 weeks to fully develop.

Botulinum toxin-related

  • Localised burning or stinging pain during injection
  • Blepharoptosis (droopy eyelid)
  • Eyebrow ptosis (droopy eyebrow)
  • Ectropian of the lower eyelid (eyelid margin eversion)
  • Lagophthalmus (incomplete eyelid closure)
  • Xerophthalmia (dry eyes)
  • Epiphora (excess tearing)
  • Diplopia (double vision)
  • Impaired blink reflex
  • Photophobia (light sensitivity)
  • Globe trauma
  • Infraorbital festooning (worsening of eyebags)
  • Lip ptosis with resultant smile asymmetry
  • Oral incompetence with resultant drooling and impaired speaking, eating or drinking
  • Cheek flaccidity
  • Dysarthria (difficulty articulating)
  • Dysphagia (difficulty swallowing)
  • Hoarseness
  • Neck weakness
  • Facial asymmetry, alteration or poor aesthetic result
  • Inadequate reduction of wrinkles or lack of intended effect in the treatment area
  • Worsening wrinkles in areas adjacent to the treatment area
  • Weakening muscles adjacent to the treatment area
  • Autoantibodies against botulinum toxin. Autoantibodies may be present or develop after injection, rendering treatments ineffective (1-2% of patients treated for cosmetic indications)
  • Extremely rare, immediate hypersensitivity reaction with signs of urticaria, oedema and a remote possibility of anaphylaxis

General Injection-related complications (can be any treatment):

  • Pain
  • Bruising
  • Erythema
  • Oedema
  • Tenderness
  • Headache
  • Infection
  • Numbness or paresthesia
  • Anxiety
  • Vasovagal episode and loss of consciousness

For most complications there are no corrective treatments and they spontaneously resolve as botulinum toxin effects diminish.



Dermal fillers are used for the treatment of facial creases, wrinkles, folds, contour defects, depression scars, facial lipoatrophy (loss of fat) and enhancement purposes. These treatments involve multiple injections of filler into or below the skin to fill wrinkles and restore volume. The effects of dermal fillers are temporary and no guarantees can be made regarding how long correction will last in a specific patient. Alternatives to temporary fillers include, but are not limited to: permanent dermal fillers, laser resurfacing and skin tightening, surgical facelift or no treatment at all.

Possible risks, side-effects, and complications with dermal fillers include but are not limited to:

  • Bruising, redness and swelling
  • Visible raised areas or bumpiness at/around the treated site
  • Asymmetry, over correction or under correction.
  • Unpredictable persistence of filler, either shorter or longer than anticipated
  • Prolonged discolouration of the skin such as brown, greyish, bluish or reddish colouration.
  • Filler material may be extruded from the skin in rare cases
  • Prolonged or severe swelling
  • Infection
  • Rarely granulomas or firm nodules may form
  • Benign tumour formation (keratoacanthomas)
  • Allergic reaction with itchiness, redness and in extremely rare cases generalised allergic response such as a whole body swelling, respiratory problems and shock
  • Scarring is extremely rare
  • Skin breakdown or ulceration
  • Tissue necrosis is extremely rare
  • Blindness


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