Risk Information

Side effects of cosmetic use of BOTOX® treatments are generally mild and include bruising, tenderness, headache or swelling.  These side effects are transient, meaning they don’t last long.  A small percentage (less than 5%) experience a temporary eyebrow droop.  Sometimes, the medical practitioner may be able to add a small amount of BOTOX® in opposing muscles to counteract or lessen the droop.  In very rare instances, a patient may temporarily be unable to lift an eyelid (ptosis), which can be treated with prescription eye drops to alleviate symptoms.  Although possible with any medical practitioner, some occurrences of these infrequent side effects are likely a result of injector inexperience. 

BOTOX® is not recommended for individuals with infections at the injection sites,  neuromuscular disorders such as ALS, myasthenia gravis or Lambert-Eaton syndrome, and is not recommended for use during pregnancy, while breastfeeding or for children under 18.  With almost any medication there can be severe risks; however, for cosmetic use of BOTOX® severe risks are very rare and include the possibility of anaphylaxis, dysphagia, dyspnea, myasthenia gravis, focal facial paralysis and spatial disorientation.  Be sure to inform your medical practitioner of any medical conditions and any medications you may be taking. 

Dysport® Risk Information

With Dysport®, there is little to no downtime after injection. Side effects are generally mild and include bruising, tenderness, headache or swelling. These side effects are transient, meaning they don’t last long. It is recommended that you should wait at least 90 days between treatments. The safety of Dysport® has been studied in up to 12 repeated treatments.(1)

Do not take Dysport® if you are allergic to any of the ingredients in Dysport®. Consult with your physician for a complete list of ingredients. Do not take Dysport® if you are allergic to cow’s milk protein, had an allergic reaction to any other botulinum toxin product, such as Myobloc or Botox®, or have a skin infection at the planned site. Dysport® may not be right for you if you have had surgical changes to your face, very weak muscles in the treatment area, your face looks very different from side to side, the injection site is inflamed, you have droopy eyelids or sagging eyelid folds, deep facial scars, thick oily skin, or if your wrinkles can’t be smoothed by spreading them apart. (1) Consult your physician for a complete list of Dysport® side effects and to determine if Dysport® is right for you. Be sure to tell your physician about all of your medical conditions, including if you have: a disease that affects your muscles and nerves, breathing problems, swallowing problems, bleeding problems, diabetes, a problem with your heart rate, plans to have surgery, had surgery on your face, weakness of your forehead muscles, drooping eyelids, any other change in the way your face normally looks. (1)

Be sure to tell your doctor if you have received any other botulinum toxin product in the last 4 months, if you have received injections of botulinum toxin in the past (and what brand was injected), have recently received an antibiotic by injection, take muscle relaxants, take allergy or cold medicine, or take sleep medicine. (1)

Dermal Fillers Risk Information

Side effects of dermal filler treatments are ordinarily mild and include redness, bruising, tenderness and swelling.  As with any injection, there is always the risk of infection, but it is rare with dermal filler treatments.  If the treatment is around the lips or mouth, and the individual has a history of cold sores or herpes virus outbreaks, the medical practitioner may prescribe specific medications like Acyclovir or Zovirax® to minimize risks of an outbreak as a result of the dermal filler procedure. 

With any of the dermal fillers, it is possible to feel a lump or lumps around the injection area that is not usually visible to the naked eye and will typically resolve with time.

With Sculptra®, massaging the area after treatment as directed by your medical practitioner will help avoid any lumps.

If Restylane® is injected too superficially, it may appear as a faint blue line under the skin.  This, too, may persist for a protracted period of time, and is less likely with an injector who has extensive experience with Restylane® procedures. 

Medical practitioners must avoid injecting Radiesse® too superficially or too close to the mucous membrane in the mouth so that it will not form any visible lumps.  If this occurs, Radiesse® should be extracted immediately by the medical practitioner.  Immediate extraction is typically easy; however, if Radiesse® is injected too superficially and is not extracted immediately, it may be difficult or impossible to extract without excision.  These lumps, in some individuals, may persist for an extended period of time, but are very rare among medical practitioners who have extensive experience with Radiesse® procedures

Dermal filler procedures should usually be postponed if there is an active skin sore, pimple, rash, cyst or infection near the proposed injection site.  In most instances, a patient should wait until the condition has resolved before undergoing a dermal filler procedure. 

In very rare instances, the injected area may react to a filler, becoming inflamed and forming a nodule, papule or granuloma.  In most cases these can be resolved with steroids and antibiotics.  In very rare instances, surgical excision may be necessary to remove a nodule, papule or granuloma.

Also in exceedingly rare instances, a medical practitioner can inject a blood vessel which could cause an embolism, necrosis or damage to the skin or an infarction.  While this is rare in any instance, a novice injector could put a patient at greater risk if the injector does not have a complete understanding of dermal filler injection technique.  For maximum safety, the injections of the fillers should take place at proper depths while the medical practitioner is withdrawing the needle.

Laser treatments, microdermabrasions, chemical peels and other skin treatments are not usually recommended at the time of dermal filler treatments.  Be sure to inform your medical practitioner of any medical conditions, as well as any medications (including anticoagulants or blood thinners) you may be taking.

For more information about potential adverse reactions, please consult the web sites of the appropriate manufacturers and your medical practitioner.

1 Source:  Medicis Aesthetics Inc.