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What can go wrong when I have an aesthetic treatment?

You’ve been considering having an aesthetic or cosmetic treatment done but you worry about what can go wrong? Hopefully, this is you doing your research. Any time you have a treatment or take medications, there could be side effects or complications. Is this what’s holding you back?


It really depends on the treatment you are having and the specific complications will be discussed at the time of consultation and again when talking through the consent for that specific treatment but for the most part here are some common or obvious ones:

Using Needles

Any time a needle is used there's a risk of pain, bleeding, bruising, swelling and infection. So let’s talk about some of these and then move on to some specific complications/risks.

Bruising:

Some areas and people are more prone to bruising. It’s probably the most unwanted side effect as it’s not that easy to hide and depending on how big the bruise is, it could take 10-14 days to fully resolve. When having anti-wrinkle injections (Botox) bruises are more likely to be pin-point and the eye area is the most common site to get one. With fillers, the bruise can be more significant and much harder to hide behind makeup.

Swelling:

Selling is another common and usually short-lived side effect - settling in a matter of hours or days. Tear trough fillers however can have this as a delayed onset. Coming on a week or more after the treatment due to patient factors and lymphatic drainage. In this case, the treatment may need to be reversed.

There have been reports of swelling of fillers months or years down the line as a response to an infection your body is fighting off, like the flu or COVID. This will settle on its own.

Infection:

Whenever a needle crosses the skin barrier there is a risk of infection. But with clean techniques and sterile products, the risk is pretty low. Each person will have variable risks depending on their immune system. Some antibiotics will help clear up anything that might not settle on its own. If you are prone to cold sores then be wearier with treatments involving the lip and mouth area as it can cause a flare-up. Often we prescribe acyclovir ahead of your treatment to reduce the risk of a flare-up.

There are complications that are particular to types of treatments. The less invasive the treatment generally the lesser the risk of complication. Energy-based devices like lasers and radio frequency might seem less invasive but do not be fooled. Let’s talk through some specific risks of treatments that I perform.

Vascular Occlusion:

A scary one when it comes to fillers is Vascular Occlusion. This is actually quite rare but very serious. If any complication puts you off treatment, it would be this one. Basically, if filler gets into a blood vessel it blocks the blood flow to the area, depriving it of oxygen. When there is no oxygen and blood in an area, it starts to die. Initially, it will be pale moving to mottled and then dark in colour. It’s here where this can be confused for a bruise. This is an emergency but luckily it can be reversed if picked up quickly! It is better to check with your practitioner if you are worried about a bruise rather than miss a vascular occlusion.

When a vascular occlusion involves blood vessels close to the eye or connections to the brain there is a risk of vision loss and even a stroke. It needs to be said - no matter how scary it sounds so that you are aware of even the smallest chance of something like this happening. You won’t believe how many people have had fillers and were never told about a vascular occlusion!

Drooping:

A potential side effect with anti-wrinkle treatments (Botox). This could happen to the brow or the eyelid. It can be slight that no one would notice except yourself or very significant and leave you looking like you’ve had a stroke. Not everyone is a candidate for anti-wrinkle treatments due to the high risk of a brow drop happening. But mostly technique and good aftercare can prevent this. There have been some discoveries in ways to reverse an eyelid droop (previously thought to just wait for it to wear off) that provide relief from this unpleasant complication.


Nodules:

Fillers can also cause nodules both immediate and delayed in onset, granulomas and abscesses. Each has a different cause and is dealt with in different ways. Removal of the filler is sometimes the only option especially if other treatments haven’t worked to relieve the problem.

Allergies:

Allergy is always a possibility. This can be to filler, anaesthetic, preservatives in products, hyaluronidase (the dissolving enzyme for fillers) and even Botox (however extremely rare).

At Fountain of Youth, Salisbury we keep an emergency kit for anaphylaxis and antihistamines and we talk through individual likelihood during the consent process.


Results:

There is also always the risk that you may not be happy with the results of the treatment! Maybe your expectations were too high and had hoped it would make more of a difference (like knock 20 years off). I try to have frank conversations with my patients and lower their expectations. Everyone is different and results are not guaranteed especially when it comes to fillers as it’s a volume thing and more may be needed. The flip of this is the procedure could leave you looking worse off... or heaven forbid, FAKE! This comes down to the practitioner, technique and suitability of the procedure for the candidate. It is essential to choose the right person for the job. Someone who is trained, experienced and safe! Look out for my blog on how to choose the best practitioner in Salisbury, Wiltshire!

Avoiding and Managing Complications

There are modalities available to help be safer (you can never be 100% safe, just safer) like ultrasound, patch testing or DNA testing. Practitioners need to be able to manage the complication, prescribe antibiotics and reversal agents, hold your hand in times of fear and distress, as well as the discernment to say no to the patient who is a high-risk patient for any of the above.

The above is not an exhaustive list. Some of the side effects are common (bleeding, bruising and swelling) and others are rare and even others super rare, but how much value you assign to each risk will be dependent on you. Take as much time as you need, do your research and ask questions as often as you like. Be sure before you proceed with aesthetic treatments. They aren’t just beauty treatments, they are medical procedures that come with risks. And you need to decide if you will psychologically be able to handle a complication. Most of all, make sure to choose your practitioner wisely. Reach out to me if you have any questions or concerns.

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