Botox and fillers are widely used treatments when they’re given for the right reason, with a licensed product, by a doctor who knows facial anatomy well. A complication is anything beyond the mild, temporary effects expected after treatment. Complications are rare, and most are mild, temporary and treatable.

Mild swelling, redness and small bruises in the first days aren’t complications; they’re the tissue’s normal response and usually pass within a few days. Complications are most often linked to:

• The wrong point or depth: the product reaching a muscle or layer it wasn’t meant for.
• An unsuitable dose: an amount not planned for the area and the person.
• Unlicensed products or poor hygiene: products of unknown origin and non-sterile conditions.
• Untrained injectors: treatment by people without training in facial anatomy.

That’s why most complications can be prevented. When they do occur, early assessment and the right approach mean most can be corrected.

The effect of botox is temporary, so unwanted effects from botox are temporary too; they fade as the product wears off. Many can be balanced without waiting that long:

• A droopy eyelid or brow: caused by the product spreading to a muscle it wasn’t meant for. It’s temporary; after a doctor’s assessment, eye drops that help lift the lid may be used, and it resolves completely with time.
• Uneven brows or a “Spock brow”: one brow lifts too much. This is usually balanced with a small dose at the follow-up visit.
• A frozen or overly tight look: linked to a high dose. Expression returns as the effect fades, and the dose is re-planned next time.
• An uneven smile: can follow treatment around the mouth; it’s corrected by balancing the other side or with time.

To learn more about how botox works and its possible side effects, read Is Botox Plastic Surgery?, and for aftercare, what not to do after botox. For all botox treatments, see our botox page.

A big advantage of hyaluronic acid fillers is that they can be dissolved if needed, so most filler problems can be corrected safely:

• Firmness, lumps and swelling: treated with massage, time or, if needed, filler dissolving.
• Filler migration: seen especially around the lips. The excess is dissolved and the area can be re-planned.
• Asymmetry or an overfilled look: balanced by dissolving part of the product or adding a small top-up.
• A bluish tint (Tyndall effect): caused by filler placed too close to the surface; corrected with filler dissolving.
• Delayed swelling or infection: assessed by a doctor, with medication or filler dissolving planned depending on the cause.

A very rare complication is filler affecting a blood vessel. Whitening, a purplish net-like discoloration or pain that keeps getting worse can be signs of this. These need urgent care; when treated early, hyaluronidase allows quick treatment.

Fillers other than hyaluronic acid, such as non-absorbable fillers, can’t be dissolved with an enzyme. In these cases, treatment is planned separately depending on the problem and the product. To see how normal healing looks after lip filler, read lip filler swelling.

Dr. Sevgi Ekiyor also assesses problems after botox or filler done elsewhere. The assessment follows these steps:

1. History: when the treatment was done, in which area and, if possible, with which product.
2. Examination: the area is examined closely to see whether the problem comes from the product, the technique or the normal healing process.
3. Plan: filler dissolving, a small balancing dose of botox, medication or simply monitoring may be recommended.
4. Follow-up: the result is checked at set intervals; once the area has fully settled, a new treatment can be planned if you wish.

Time passing since your treatment doesn’t mean it can no longer be corrected. But in some situations, especially a blood vessel problem, seeking care early makes a real difference. If you notice anything unexpected, contact a doctor without waiting.

Most complications can be prevented by the right choices before treatment:

• Treatment by a doctor: botox and filler should be done by a doctor who knows facial anatomy and can manage a problem if one arises.
• Licensed products: you can ask for the name and source of the product being used.
• A proper consultation: always mention your medication, allergies and previous treatments.
• Following aftercare: sticking to the advice for the first hours and days helps the product stay where it was placed.
• Keeping your follow-up: a check-up allows the result to be assessed and small adjustments made.

You can see which filler is used where on our dermal fillers page, and the low-dose technique preferred for natural results on our Hollywood Botox page.