12 Tips for Managing Botox and Filler Complications

Updated: Jan 9





​Prolonged pain, tenderness, and erythema

Evaluation and seek advise from prescriber for infection specific treatment


Ecchymosis is the medical term for the common bruise

​needle insertion marks to larger ecchymoses or, hematomas

Erythema and edema usually resolve within a few hours after treatment

​Immediate application of a cold compress and pressure. Firm compression

Use arnica for 3-4 days

Facial paresis or asymmetry

Spock eyebrow

Uneven results from dermal filler or dent

​place additional Botox at the active area on the frontalis.

correct the problem using a more durable filler if safe to do so.

Under correction is always better and safer than overcorrection


Immediate and firm massage may resolve the blanched effect, although vascular compromise must be ruled out.

Tyndall Effect

bluish hue due to filler being placed too superficially

​Firm massage may resolve if done when firm noticed. If massage is unsuccessful then dissolving the filler with hyaluronidase will resolve it

Vascular complications

Arterial/venous occlusion can lead to skin necrosis

Pain, changes in skin colour, mottled pattern, ischemia, poor capillary refill, blisters, tracking

​Firm massage and heat to the area, if not resolved then mix up 1mil to 5 mil of saline with 1500IU of hyaluronidase. And inject hyaluronidase along the course of the vessel and through out the procedure, massage vigorously to optimise the result and aid mechanical breakdown

Herpetic outbreak

Reactivation of herpes virus

​Advise clients to take their anti herpes medication before the treatment to avoid

Lumps and Bumps

Soft spongy bump inside the skin.

​Massage to resolve.

Hard or tender lumps may be an indication that the body is experiencing a mild allergic reaction.If this is the case the client may need medical intervention and steroids to resolve


Small ball or nodule.Can be inflamed and be painful, cause tenderness and erythema or redness

​Treatment includes massage and steroids


Dermal filler which has spread to another area

​Firm massage to replace the product or dissolve using hyaluronidase

Allergic reaction

Some allergies can lead to a severe allergic reaction - known as anaphylaxis. Anaphylaxis can be life-threatening.

- Hives

- Difficulty breathing/swallowing

Increased heart rate

​Anaphylaxis must be treated promptly. Call 999 and state anaphylaxis

If you have an adrenaline auto-injector - it should be used immediately


Pain during the procedure. Always check on clients wellbeing. If the pain is sever, check for other complications such as vascular complications

​Dermal fillers which contain lidocaine can help to reduce pain during the procedure


Written by

Angela Blemmings

EyeCandy Training Ltd

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