Not everyone feels confident saying yes to injectable treatments like Botox or dermal fillers — and that’s completely understandable. According to the Merz Aesthetics Confidence Beyond the Mirror Study, 11% of people who avoid injectables say it’s because they don’t fully understand the risks involved.
This concern is valid — and actually quite welcome. In fact, more people should pause before undergoing any aesthetic procedure. But once the question is raised, the next step is education. This article outlines the key risks of Botox, the risks of dermal fillers, and why proper consultation is essential to making a truly informed decision.
A Rare but Welcome Pause
Wanting to understand the risks before treatment is a thoughtful and commendable attitude. Medical aesthetic treatments should never be taken lightly, and it’s refreshing to see patients who are cautious, even if this group is in the minority.
In fact, only 11% of surveyed individuals identified this lack of knowledge as their main reason for avoiding injectables. Ideally, that number would be much higher. Aesthetic decisions, like all health decisions, deserve careful consideration and professional guidance.
A Bit of Gentle Irony
There’s an irony worth noting here. While some people hesitate to try injectable treatments due to concerns about risk, many make daily choices with far more significant health consequences — often without a second thought.
Consider:
- Smoking
- Regular alcohol consumption
- Eating highly processed or carcinogenic foods
- Inhaling chemical-laden deodorants or hair sprays
- Lack of exercise, chronic stress, and poor sleep
These are widely accepted lifestyle habits, yet their risks are rarely discussed with the same caution. In contrast, treatments like Botox or fillers — when performed correctly — are safe and well-studied. So it’s not the caution that’s the problem. It’s the inconsistency.
Ideally, patients would apply the same level of care and education to all health decisions, not just cosmetic ones.
This Is Exactly Why Consultations Exist
Not understanding the risks of injectables is not a reason to avoid treatment — it’s a reason to attend a professional consultation.
A proper consultation gives patients the opportunity to:
- Share their concerns, goals, and expectations
- Learn how the face naturally ages and how this affects appearance
- Understand treatment options, including Botox and fillers
- Explore the pros, cons, and risks specific to their own facial anatomy and lifestyle
- Ask questions in a pressure-free setting
At clinics like the Chiswick Clinic, these initial consultations are not sales meetings. They’re a chance to learn. And after a 45-minute session with a medical aesthetic practitioner, patients are usually in a much stronger position to decide — whether they say yes, no, or “not yet.”
The Real Risks of Botox
Botox is a purified protein used to relax overactive muscles. It is approved for both cosmetic and medical use and has one of the most well-documented safety profiles in the aesthetic field.
Common Botox Side Effects:
- Mild bruising or swelling
- Temporary headaches
- Slight asymmetry
- In rare cases, eyelid or eyebrow drooping (resolves naturally over time)
Despite the name, there is nothing inherently toxic about Botox when administered correctly. In fact, the term “toxin” often misleads patients into thinking they are injecting something dangerous into their body. In medical doses, Botox is not only safe — it has been used for decades across a wide range of treatments, including migraine relief, excessive sweating, and muscle spasms.
The Risks of Dermal Fillers
Dermal fillers, most often made from hyaluronic acid, are used to restore volume and contour facial features. While generally safe, they carry a slightly different risk profile compared to Botox due to their physical nature.
Common Filler Side Effects:
- Swelling, redness, or bruising
- Tenderness at the injection site
- Small lumps or bumps (usually resolve on their own)
Rare but Serious Risks:
- Vascular occlusion — where filler enters a blood vessel, leading to restricted blood flow
- Skin necrosis (tissue damage)
- Scarring or discolouration
- Blindness in extremely rare cases, especially with improper injection near high-risk areas
These risks are not presented to create fear but to encourage respect for the procedure. Proper injection technique, in-depth anatomical knowledge, and practitioner training significantly reduce the likelihood of complications. Still, every patient has the right — and responsibility — to be informed.
First-Time Botox and Filler Advice: Follow Aftercare
Understanding risks includes knowing how to minimise them. Patients can support safe outcomes by following simple aftercare instructions:
- Avoid alcohol and strenuous activity for 24–48 hours
- Don’t touch or massage the treated area
- Avoid makeup for 24 hours
- Report any unusual symptoms promptly
- Keep the area clean and avoid excessive heat (e.g. saunas)
Who Should Avoid Injectable Treatments?
Not everyone is a candidate for injectables. Patients may be advised against Botox or fillers if they:
- Are pregnant or breastfeeding
- Have a localised skin infection at or near the planned injection site
- Have certain neurological or autoimmune conditions
- Are unwilling or unable to follow post-treatment guidance
An initial consultation will help determine medical suitability.
Still Not Sure? That’s Okay — Just Learn First
Hesitation doesn’t mean treatment isn’t right. It simply means more information is needed. Education is the bridge between fear and confidence.
This is why Dr. Bela developed the Safe Aesthetic Treatment Campaign, including the downloadable Safe Aesthetic Treatment Checklist — a simple, honest tool that helps patients choose qualified practitioners, understand the risks involved, and ask the right questions before treatment.
Being cautious is not a sign of weakness — it’s a sign of maturity.
So, Should You Get Botox or Fillers?
Only the patient can make that decision. But here’s what’s clear:
- In skilled hands, Botox and fillers are safe, evidence-based treatments
- The risks are manageable and rare
- A consultation is the safest, most ethical starting point
- Ignorance is more dangerous than education
Patients don’t need to say yes on the day. They simply need to start the process of understanding. As with most things in medicine, informed decisions lead to better outcomes.
Final Thoughts: From Hesitation to Confidence
To those 11% who say, “I don’t understand the risks well enough to decide,” the message is simple: that’s not an excuse — that’s an invitation.
An invitation to learn. To ask. To explore. To make choices based on knowledge, not guesswork.
The consultation exists for this exact reason — and delaying it by months or years changes nothing except the timeline. The face continues to age while the fear remains unchallenged.
If there’s one message to take away, it’s this:
Don’t let uncertainty hold you back. Let education move you forward.
