Fillers are generally safe when performed by licensed staff, but there are risks with fillers — from common, temporary side effects to rare but serious complications. This guide goes through everything you should know before you book a treatment.
Common side effects — usually mild
Most people experience some of the following during the first 3–7 days:
- Swelling
- Bruising
- Redness
- Tenderness at the injection site
- Slight asymmetry during the first week
- Headache (more common with Botox, but also occurs with fillers)
This is normal and resolves without treatment.
Less common complications
- Lumps (nodules): Small accumulations of product. Can be massaged away or dissolved with hyaluronidase.
- Migration: When the product "wanders" from the injection site — most common with overfilling of the lips.
- Granuloma: An inflammatory reaction, rare.
- Infection: Uncommon, but requires prompt antibiotic treatment.
- Allergic reaction: Very rare with hyaluronic acid.
- Tyndall effect: A bluish tint through the skin after a superficial injection (most common in the tear troughs).
Serious risks — rare but life-threatening
Blood vessel occlusion (vascular occlusion)
The most serious complication. Filler is accidentally injected into a blood vessel → blood flow is blocked → tissue damage or necrosis.
Warning signs (require emergency care):
- White, grey or dark skin around the injection site
- Severe pain that does not resemble normal tenderness
- Sudden changes in vision
- Severe dizziness or loss of consciousness
Vascular occlusion must be treated with hyaluronidase within hours. That is why it is critical that the practitioner has hyaluronidase on site.
Effects on vision
Very rare but documented: if filler reaches the retinal artery, blindness can occur. The risk is highest in the area between the eyebrows (glabella) and the nose.
How can you minimise the risks?
- Choose a licensed practitioner — a physician, nurse or dentist with specialist training in aesthetics.
- IVO-registered clinic — a legal requirement in Sweden.
- Hyaluronidase on site — ask before you book.
- Avoid cheap treatment abroad or unqualified practitioners.
- Medical consultation before treatment — Before an aesthetic injection treatment, a cooling-off period of at least two days applies after you have received the information about the treatment. If the same type of injection treatment is repeated within six months, no new cooling-off period is required.
- Tell the practitioner about medications and illnesses — blood thinners increase the risk of bleeding.
- Avoid alcohol for 24 hours before (increases bruising).
Who should avoid fillers?
- People who are pregnant or breastfeeding
- People with an active skin infection or herpes outbreak
- Certain autoimmune diseases (discuss with a physician)
- People with a known allergy to the product
- Under 18 years of age (not permitted for aesthetic injections since 2021)
If something goes wrong — what should you do?
Contact the clinic immediately if you experience:
- Severe pain that gets worse
- Discolouration of the skin (white, grey, dark)
- Changes in vision
- High fever or signs of infection
For acute symptoms — call 112.
Are fillers worth the risk?
For most people, fillers are a safe choice when performed professionally. The vast majority have only mild, temporary side effects. The key is choosing the right practitioner.
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Detailed safety analysis
Risk ladder — from mild to serious
| Level | Risk | Frequency | Action |
|---|
| 1 | Swelling, bruising | 70–90% | Heals on its own in 3–7 days |
| 2 | Headache, redness | 20–30% | Paracetamol, rest |
| 3 | Asymmetry in the first week | 5–10% | Assess after 14 days |
| 4 | Lumps, migration | 1–3% | Hyaluronidase / massage |
| 5 | Infection | < 0.5% | Antibiotics, seek urgent care |
| 6 | Vascular occlusion | < 0.1% | URGENT hyaluronidase within hours |
| 7 | Visual disturbance | < 0.01% | 112 immediately |
- 🚨 White, grey or dark blue skin around the injection site
- 🚨 Severe pain that gets worse (not normal tenderness)
- 🚨 Sudden changes in vision or double vision
- 🚨 Difficulty breathing or swallowing
- 🚨 Fever > 38.5 °C + spreading redness (infection)
- 🚨 Marked asymmetry that gets worse
- 🚨 Loss of muscle control far from the injection site
For acute symptoms: Call 112 or go straight to the emergency department. For moderate symptoms: contact the clinic within 24 hours. All reputable clinics have an on-call service for such cases.
Checklist — how to verify that a clinic is safe
- Licence: Check the practitioner's licence at legitimation.socialstyrelsen.se. They must be a physician, nurse or dentist.
- IVO registration: The clinic should be listed in IVO's register — search at ivo.se.
- Hyaluronidase on site: Ask directly. If the answer is "no" or unclear — choose another clinic.
- Product name visible: Ask to see the original packaging before the treatment.
- Patient records: A legal requirement. You should receive written documentation.
- Statutory cooling-off period: Before an aesthetic injection treatment, a cooling-off period of at least two days applies after you have received the information about the treatment. If the same type of injection treatment is repeated within six months, no new cooling-off period is required.
- Written consent: A legal requirement. You should sign an informed consent form.
- Follow-up included: A check-up visit after 2 weeks.
- Clear price: A written quote with no hidden costs.
- Credible reviews: Reviews with concrete details about the treatment are the most reliable.
- Pregnancy and breastfeeding: Injection treatment is advised against entirely.
- Neuromuscular disease (myasthenia gravis, ALS, etc.): Contraindicated for Botox.
- Blood-thinning medication: Increases the risk of bleeding — requires an additional consultation with a physician.
- Autoimmune diseases during an active flare: May increase the inflammatory reaction.
- Active herpes or skin infection: Wait until it has healed.
- Previous filler complications: Discuss with the practitioner — hyaluronidase may be needed first.
