Fillers are safe when administered by licensed staff, but filler side effects do exist — from common mild ones to rare serious ones. This guide is a complete overview.
Common side effects (> 10%)
Occur in most people and are temporary:
- Swelling — 3–7 days, most common in the lips
- Bruising — 3–14 days
- Redness — 1–3 days
- Tenderness to the touch
- Slight asymmetry in the first week
- Tightness or a feeling of heaviness
- Mild itching
Less common side effects (1–10%)
- Lumps (nodules) — soft accumulations of product. Massaged out or dissolved with hyaluronidase.
- Migration — the product "wanders" from the injection site. Read Can fillers move?
- Tyndall effect — a bluish tint from superficial injection, most often in the tear troughs
- Granuloma — inflammation after several months, uncommon
- Prolonged swelling — > 2 weeks, requires evaluation
Rare but serious side effects (< 1%)
Vessel occlusion (vascular occlusion)
The most serious complication. Product is injected into a blood vessel → blood flow is blocked → tissue necrosis.
Warning signs (emergency!):
- White, grey or dark skin around the injection site
- Severe pain that gets worse
- Pallor that does not go away
- Sudden changes in vision
Treated with hyaluronidase within hours. Seek emergency care if you see this!
Effects on vision
If product reaches the retinal artery via the blood vessels of the glabella → blindness. Extremely rare but documented. The risks are highest with:
- Nose fillers
- Injection between the eyebrows (glabella)
- Tear troughs
- Nasolabial folds
Infection
- Uncommon, but possible
- Signs: worsening redness, warmth, pus, fever
- Treated with antibiotics
Herpes reactivation
In people with herpes simplex, injections in the lips can trigger an outbreak. Antiviral prophylaxis (Valtrex) can be given preventively.
Allergic reaction
Very rare with modern hyaluronic acid fillers, as the product is almost identical to the body's own HA.
Side effects by area
Lips
- Swelling is most pronounced here
- Risk of herpes reactivation
- Sensitivity to touch for 1 week
- Bruising most common
Cheekbones
- Less swelling than in the lips
- Greater risk of lumps with deep injection
- May feel tight for 1 week
Nose
- Highest risk of vascular occlusion
- Should only be performed by a very experienced practitioner (preferably a physician)
Tear troughs
- Highest risk of the Tyndall effect
- Can cause long-lasting swelling
- Requires specialist knowledge
How can you reduce the risk?
- Licensed practitioner — physician, nurse or dentist
- IVO-registered clinic
- Hyaluronidase available — always ask
- Avoid blood thinners for 3–7 days beforehand (only over-the-counter ones, not prescription ones)
- Avoid alcohol for 24 hours beforehand
- Disclose medications and medical conditions
- Avoid exercise and hot environments for 24 hours afterwards
When should you seek care?
Emergency (call 112 or go to the emergency department):
- Sudden change in vision
- Very white, grey or black skin
- Severe pain that gets worse
- Difficulty breathing
Within 24 hours:
- Signs of infection (pus, fever)
- Marked asymmetry
- Strong allergic reaction
Compare filler clinics on Skönhetskollen.
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Detailed safety analysis
Risk ladder — from mild to serious
| Level | Risk | Frequency | Action |
|---|---|---|---|
| 1 | Swelling, bruising | 70–90% | Heals by itself in 3–7 days |
| 2 | Headache, redness | 20–30% | Paracetamol, rest |
| 3 | Asymmetry in the first week | 5–10% | Evaluate 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 |
Warning signs — seek care immediately if you have any of these
- 🚨 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
If you have acute symptoms: Call 112 or go straight to the emergency department. If you have 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. 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.
- Medical records: 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: Legal requirement. You should sign an informed consent form.
- Follow-up included: A check-up visit after 2 weeks.
- Clear pricing: A written quote with no hidden costs.
- Credible reviews: Reviews with concrete details about the treatment are the most reliable.
Who should be extra careful?
- Pregnant and breastfeeding women: 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 in an active flare: May increase the inflammatory reaction.
- Active herpes or skin infection: Wait until it has healed.
- Previous filler complications: Discuss with your practitioner — hyaluronidase may be needed first.
The expected breakdown of filler is not the same as a complication — an even, gradual fading is normal. For the timeline, see data on how long lip filler lasts.
