Adverse side effects are always a risk with any medical procedure. Sometimes, the possibility of experiencing negative side effects prevents people from undergoing treatment. Today, our aim is to manage and alleviate those fears as they relate to injectables. Injectables are medications delivered by inserted needles through the skin. The three main categories of injectables are: neuromodulators, dermal fillers, and deoxycholic acid. (The brand name for deoxycholic acid is Kybella and this treatment can be used to dissolve small areas of fat, such as underneath the chin.) The wonderful thing about neuromodulators and dermal fillers is they’ve been approved by the FDA to be both safe and tested. This means if you’ve heard any horror stories, they are most likely the result of improper application performed by untrained individuals. Of course, you should always seek out a trained professional with plenty of experience to deliver any injectable. The side effects discussed here today are mild and, if you experience them at all, short-lived. We hope knowing in advance what types of side effects to expect will help you prepare and mitigate any fear surrounding your procedure.
Side Effects of Neuromodulators
Since both are injectables, neuromodulators and dermal fillers share many of the same side effects. You can expect minor bruising, redness, and swelling at the area where the injection was placed. You can have an allergic reaction to botulinum toxin type A, which will be characterized by intense itching, a rash, and difficulty breathing and swallowing. Other symptoms which are possible but not common are: nausea, loss of appetite, muscle stiffness, sore throat, runny nose, and dry mouth or eyes. You may experience an increased sensitivity to light or a ringing in your ears.
In certain instances, neuromodulators such as Botox can migrate outside of the initial injection area. You should keep an eye out for changes in your appearance long after your initial treatment (but keep in mind, neuromodulators wear off in half the time fillers do). Another uncommon side effect of Botox is the formation of antibodies which lessen the efficacy of the neurotoxin. In the event Botox is no longer able to yield optimal results, Xeomin is a specially formulated version of botulinum toxin type A and can be used instead.
Side Effects of Dermal Fillers
Dermal fillers are often used to add volume to the face, as well as to smooth out fine lines and wrinkles. While dermal fillers are also approved for injection into the backs of the hands, they are not approved for any other part of the body. Beware dermal fillers advertised as breast or buttocks augmentation, as no injectable has been approved for large-scale body contouring by the FDA. Most temporary fillers utilize one or more of these ingredients: collagen (either purified bovine or human), hyaluronic acid gel, calcium hydroxylapatite (a mineral), or Poly-L-lactic acid (PLLA, a synthetic). If you are allergic to any of these materials, you’ll need to discuss your treatment options with your medical provider in further detail. Dermal fillers are not permanent. After application, most dissolve and are absorbed by the body after about six months, sometimes longer.
The most commonly reported side effects of dermal fillers are minor in nature. Temporary bruising around the injection site can be expected. The needle, when inserted through the skin, is likely to puncture one or two blood vessels (particularly around the highly vascular mouth and tear troughs). These bruises are the same which occur when you get a shot in your arm. They will fade steadily in the days after your appointment and should completely disappear within a week. You should avoid taking medications which can thin the blood at least a week before your appointment. This includes pain medication such as aspirin, certain vitamins, and other NSAIDs. And, if you have a blood thinning disorder which prevents your blood from clotting, please let us know! Applying a cold compress to the injection site will trigger vaso-constriction (i.e. slow the release of blood from broken vessels) which can help minimize bruising. This remedy has the added benefit of bringing down swelling, which can also be a side effect of dermal fillers. Redness around the injection site is normal as well. Redness, bruising, swelling—these are all the body’s healing response kicking into high gear.
One side effect many don’t expect from dermal fillers—but which is perfectly normal—is moderate itching around the injection site. As the body works to heal the minor damage from the needle and adjust to the presence of the filler, itchiness signals this work is taking place. The itchiness should not be severe or persist after a dose of Benadryl. If the itching is severe and does persist, this may indicate you are having an allergic reaction. In this case, you should reach out to your medical provider and discuss returning to the facility where you received treatment.
Like any injection, dermal fillers can feel like a slight pinch when applied. This pain is to be expected. However, pain which endures hours after your injection is uncommon. Similar to persistent itching, you should reach out to your medical provider for information on how to proceed.
Less Common Symptoms
Less common symptoms of dermal fillers include infections, bumps, and discoloration of the skin. Infections can be the result of unclean needles or a compromised immune system. That’s why it’s important to only receive injectables from licensed medical professionals and to inform them of any diseases or illnesses which might leave you predisposed to developing an infection. Lumps and bumps are often the result of bruising and swelling. With time, these deposits of filler often settle and resolve themselves. Usually, a gentle massage is all that’s needed to encourage bumps to flatten out in two weeks. If bumps are the result of an infection, they will be accompanied by tenderness, pain, and pus. If a bump is bothering you, always reach out to your medical provider and ask for an opinion.
The most rare side effects only occur when dermal filler is injected directly into a blood vessel. Any licensed medical professional will take great care to ensure when dermal fillers are injected they are placed just below the skin and do not interfere with any blood vessels.
Your Skin Is As Unique As You Are
Keeping patients informed is part of our duty of care. Nothing mentioned here is meant to scare you—quite the opposite! Now, you have a better understanding of what’s common as far as injectable side effects go. Any other concerns you may have can and should be addressed to us.
Everyone’s medical situation is different and, unfortunately, Google cannot account for many specifics. We’re happy to discuss injectables and their side effects in more detail during your consultation. We’ll speak about your worries, how to mitigate risk, then make a plan for how to proceed.