Botox risks

What can go wrong with BOTOX®?

Most people have heard of BOTOX®.

BOTOX® is a trademark of a botulinum toxin product. This toxin is a prescription only medicine (POM) and is not legally allowed to be advertised. 

The Advertising Standards Agency (ASA) state that Botox is prohibited to be advertised to the public, whether directly as a product to purchase, or indirectly as a treatment.

In Clinic I use this brand as well as Azzalure, Bocouture, and Alluzience. These are all brand names of Botulinum Toxin.

How safe is Botulinum Toxin or Botox?

Despite Botulinum Toxin being a really safe drug and very unlikely to cause any problems, there can be times when something goes wrong.

Even in the hands of a skilled practitioner with years of experience, the risks are minimised, but there are still some risks and side effects.


Bruising or bleeding. It is an injection so there is a small risk of this. However the needles used at Flawless Aesthetic Clinic are tiny, barely any bigger than the ones used for acupuncture.

Most people have no problems and, if any bruising does take place, it can be minimised with cold compresses and arnica gel and can usually be covered with a little foundation or cover stick.


Infection. Again, because a needle is penetrating the skin there is a theoretical risk of this, however, the puncture really is minute and the skin is cleaned and disinfected before any treatment.


Headache. This is a bit of an odd one, but some patients describe a ‘headache’ or odd sensation when they have their first Botox treatment (or have a very large gap between treatments).

This can happen when the forehead area or between the brows is treated. It isn’t really a headache as such, but your brain trying to figure out why the muscles are not moving as much as they were.

The good news is this usually only happens first time round and usually disappears after a few days.

Too much Botox

Too much Botox being used. Over-treatment can lead to that frozen look that none of us aspires to.

There is a reduction in the ability of the facial muscles in the treated areas to act in their normal way to show our emotions.

Thankfully, this look is going out of fashion and a skilled practitioner knows how to avoid it. If it does happen to you then the only cure is time. Gradually the effects will wear off starting after about 6 weeks.

Botox longevity

Heavy Brows and Eyelids

Eye brow heavy from Botox

The risks of Drooping eyelids or brows are very small if the practitioner knows their anatomy and knows how to assess the face properly prior to the Botox injections.

Inexpert placement or too much of the toxin can lead to it spreading to a neighbouring muscle and an eyelid drooping down (also known as ptosis) that can last for many weeks. This can be partially reversed by tiny amounts of precisely placed botox or by using a prescription-only eyedrops that can help open the eyelids a bit more.

Whenever you get a Botox treatment your practitioner should tell you to keep upright for a few hours afterwards to reduce the risk of the toxin drifting away from where it was placed which can also cause asymmetry or lid/brow droop.

The same goes for having a facial massage or rubbing the area too vigorously for the first few hours.

In Summary

Despite all of the above possibilities, Botox remains one of the safest treatment that is offered in aesthetics. Side effects are rare and when they do happen they are temporary, as with everything in life, make sensible choices about who does your treatments and you further reduce the risks of anything untoward happening.


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