Reducing the Risk of Complications: 15 Precautions Before, During and After an Aesthetic Treatment

Can the risk of complications really be reduced?

Yes, but it cannot be eliminated completely. With procedures such as botulinum toxin (commonly called “botox”), filler, laser and peels, most side effects are mild and temporary; conditions such as vascular occlusion, serious infection or a severe allergy are rare. Expert consensus reports highlight the right patient selection, informed consent, good preparation, careful injection technique and recognition of warning signs by both the physician and the patient as key to reducing the risk.

The technical part is the physician’s responsibility. But the steps in your own hands are not few either: whom and where you choose, what you tell the physician, which questions you ask and how you behave after the procedure can directly affect the outcome. The 15 precautions below summarise these steps in order.

What should I do before the procedure? (Precautions 1–7)

1. Choose the right physician and a licensed healthcare facility. Find out who will perform the procedure, their training and experience in this area, and whether the facility is licensed as a healthcare facility. Stay away from places that are not healthcare facilities, such as homes, salons or hotel rooms. For a detailed check, you can use our article “A 10-Point Safety Checklist for Choosing a Clinic and Physician for Medical Aesthetics”.
2. Ask for a face-to-face consultation. A treatment decision made on the basis of a photo, a message or social media is not safe. At the consultation, your skin, your facial structure and your expectations are assessed; you may also be told that the procedure is not suitable for you.
3. Give a complete and honest account of your medical history. Mention all the medicines you take (including blood thinners), herbal products and supplements, allergies to medicines and local anaesthetics, any serious allergy to bee or wasp stings, use of oral acne medicine (isotretinoin), pregnancy, plans for pregnancy or breastfeeding, a history of cold sores, a tendency to scar easily or to form keloids (raised scars), any immune system diseases and any fillers you have had before (when, where and, if you know, which type). For pregnancy and breastfeeding, see the article “Medical Aesthetics in Pregnancy and Breastfeeding”.
4. Find out which product will be used. Ask about the product’s active ingredient (for example, hyaluronic acid), whether it is licensed and whether it has been obtained from a traceable source. For the risks of products sold online, of unknown origin or very cheap, you can read our article “Counterfeit Products and Unlicensed Treatments”.
5. Really read the informed consent and ask about complication management. Find out about possible side effects, rare but serious risks and the alternatives. Ask clearly what will be done if there is a problem: for hyaluronic acid filler, does the facility have the enzyme hyaluronidase and emergency facilities, and whom will you contact outside working hours?
6. Form realistic expectations. Discuss what result is possible, how long it will last and what cannot be done. More product or more frequent procedures do not always mean a better result; excessive expectations can lead to more procedures than necessary and therefore to more risk.
7. Get the timing right. Do not plan a procedure just before an important event such as a wedding, a presentation or a holiday; allow time for swelling and bruising. If you have an intensive sunny holiday coming up, a feverish illness, active spots or a cold sore in the treatment area, or another medical procedure planned soon, tell your physician; postponement may be necessary.

Do not stop a blood thinner or any other prescription medicine on your own for the procedure. Any change to a medicine should be planned together with the physician who prescribed it. Also ask in advance about supplements that may increase the risk of bruising.

What should I pay attention to during the procedure? (Precautions 8–11)

1. Have the product information recorded. The boxes of many injectable products carry a label showing the production batch (lot) number. Ask for the product’s name, active ingredient, batch number and the date of the treatment to be entered in your file and given to you in writing. If you have a problem years later, this information makes your physician’s work much easier.
2. Make a clean start. If possible, come to the procedure without make-up. You can check that the skin is cleaned and disinfected before the treatment and that single-use materials are opened in front of you.
3. If you feel anything unusual, say so immediately. If you notice pain much more severe than expected, whitening of the skin, blurred or darkening vision, dizziness, shortness of breath or widespread itching during the procedure, tell the physician immediately. Problems noticed early can be dealt with early.
4. Get your instructions in writing before the procedure ends. Do not leave without finding out which symptoms are normal, for which ones you should call and whom to contact outside working hours. If your physician recommends it, staying at the facility for a short time after the procedure to be observed also increases safety.

How can I reduce the risk after the procedure? (Precautions 12–15)

1. Follow the aftercare instructions. Rules such as not pressing on or rubbing the treated area, avoiding strenuous exercise, saunas and Turkish baths (hammams) in the first hours and days, and protecting yourself from the sun after laser and peels vary from one procedure to another. For general principles, see our article “Aftercare Following Medical Aesthetic Procedures”.
2. Know the warning signs and do not wait. Learn which symptoms are normal and which are urgent from the table below and from our procedure-specific articles. If you are not sure, call your physician.
3. Do not try to treat yourself. Do not use antibiotics or steroid creams you have at home or a medicine someone else recommended; do not try massage, heat or dissolving methods suggested on social media; do not have a new procedure on the same area somewhere else before the problem is resolved.
4. Go to the follow-up appointment and keep records. If your physician has recommended a follow-up, do not skip it. Taking photos of the area in the first days is useful for showing changes to the physician. Keep your product information and mention it to the physician at every future procedure.

What is normal, when should you call the physician, and when is it an emergency?

For details of filler-specific emergency symptoms, see our article “After Fillers: When Is It an Emergency?”. What to do step by step if you have a problem is explained in the article “What Should You Do If a Complication Occurs after an Aesthetic Treatment”.

What can the physician do if there is a problem?

The physician first determines what the problem is through an examination, because conditions that look similar are treated differently. For example, with vascular occlusion caused by hyaluronic acid filler, the physician can use the enzyme hyaluronidase, which dissolves the gel; if infection is suspected, appropriate tests and treatment are planned; for a severe allergy, emergency treatment is started; and for a drooping eyelid due to botulinum toxin, monitoring and some supportive options are usually discussed. When necessary, referral to other specialists in areas such as eyes, infection or wound care is made.

This is why the ability of the person performing the procedure to recognise and manage complications is as important as the procedure itself. Some treatments make these interventions more difficult: fillers other than hyaluronic acid and permanent fillers cannot be dissolved with hyaluronidase.

What can I do at home, and what should I avoid?

• You can: use the skincare products your physician recommends, apply brief cold compresses that do not touch the skin directly if recommended, rest with your head slightly raised, keep the area clean and track changes with photos.
• Don’t: massage, apply warm compresses, pick off crusts, start or stop a prescription medicine on your own, or suppress the complaint with painkillers and wait, unless the physician tells you to.
• Don’t: have a corrective procedure on the same area at another facility before the problem has become clear.

What are the procedure-specific risks?

Each procedure has its own risks, and the precautions vary accordingly. Our articles “Filler Complications” for filler, “Side Effects after Botulinum Toxin” for botulinum toxin and “Burns and Pigmentation Changes after Laser and IPL” for laser and light devices describe procedure-specific details. We also have separate guides on problems common to all procedures, namely signs of inflammation, expected bruising and allergy to medicines or products: “Infection after Aesthetic Treatments”, “Bruising and Swelling” and “Allergic Reactions in Aesthetic Treatments”.

What does the scientific evidence say about these precautions?

Most of these precautions are based on expert consensus reports, guidelines and clinical experience rather than on large randomised trials. For example, how much some precautions reduce the risk on their own has not been precisely measured, and experts disagree on some technical points. Even so, there is broad agreement on the importance of choosing the right person and place, a complete medical history, a licensed product and early recognition of warning signs.