risks associated with anti-wrinkle injections:

Common & Temporary Side Effects

These are generally mild and resolve in a few hours to a few days:

• Redness, swelling, or bruising at the injection site

• Headache (especially after forehead injections)

• Tenderness or mild pain at the injection site

• Slight asymmetry (often temporary and correctable)

Around the Eyes (Crow’s Feet, Frown Lines)

• Eyelid droop (ptosis) – if the toxin spreads to the levator muscle

• Eyebrow droop or uneven brows

• Dry eyes or excessive tearing

• Double vision or blurred vision (very rare)

Forehead (Horizontal Lines)

• Heavy or “frozen” forehead – overtreatment can lead to stiffness

• Brow ptosis – brows may drop and make the eyes look tired

• Asymmetrical brow movement

Around the Mouth (Lip Lines, Smile Lines – used cautiously here)

• Drooping of the mouth corner

• Difficulty with speech, smiling, or drinking through a straw

• Uneven smile or “crooked” grin (if injected near the zygomatic muscles)

Jaw & Lower Face (Masseter, Chin, Neck)

• Difficulty chewing (if masseter is overtreated)

• Smile asymmetry (if toxin affects nearby muscles)

• Weakness in facial expression

• Speech or swallowing issues (very rare and dose-related)

More Serious (but Rare) Risks

• Toxin spread beyond intended area, causing generalized muscle weakness

• Allergic reactions (rash, itching, or severe response – very rare)

• Infection at the injection site (rare, if aseptic technique is not used)

 risks associated with DERMAL FILLER injections:

Common and Temporary Risks

These side effects are expected and typically resolve within a few days to 2 weeks:

• Redness, swelling, or bruising at the injection site

• Tenderness or pain

• Itching or a “lumpy” feeling

• Temporary asymmetry (may improve as swelling goes down)

These are more likely in areas with thin skin or lots of movement (e.g., lips, under eyes).

Moderate Risks

These are less common but may need correction or medical management:

• Lumps or nodules under the skin

• Tyndall effect: a bluish tint under the skin if filler is injected too superficially (common with under-eye filler)

• Overfilling or unnatural appearance

• Infection – rare but possible if sterility is compromised

• Delayed inflammatory reactions (e.g., swelling weeks to months later) – possibly triggered by illness or vaccines

Serious Risks (Rare)

1. Vascular Occlusion (Blocked Blood Vessel)

This is the most serious risk associated with dermal fillers.

• It occurs when filler is accidentally injected into a blood vessel

• It can lead to skin death (necrosis), permanent scarring, or even blindness if it is near the eyes

Warning signs include:

• Severe pain during or after injection

• Whitening or dusky skin color

• Coldness or mottling of the skin

• Blistering or dark patches after treatment

This is a medical emergency. It must be treated immediately with hyaluronidase (an enzyme that dissolves hyaluronic acid fillers).

2. Blindness

Extremely rare (estimated at 1 in 100,000 to 1 in 1,000,000), but irreversible if it happens.

• Most associated with fillers injected around the glabella (frown lines), nose, and tear troughs

• Caused by filler entering blood vessels connected to the eye’s blood supply

3. Granulomas or Delayed-Onset Nodules

• Can appear weeks to months later

• Usually inflammatory in nature

• May require steroids, hyaluronidase, or surgical intervention

Long-Term Considerations

• Migration of filler – shifting of product to nearby areas (e.g., filler injected in the lips can migrate above them)

• Stretching of tissue with repeated overfilling

• Scarring or fibrosis (rare, usually from repeated trauma or complications)