Safety
Recognising complications: from a drooping eyelid to asymmetry
In brief
Most unwanted effects are mild and temporary: a bruise, a headache, a slightly uneven result. Rarer is a drooping eyelid or a lowered eyebrow, usually caused by the product spreading to a neighbouring muscle. That resolves on its own within weeks to months and can be partly offset with eye drops. Serious complications are very rare.
Mild and common
A bruise, small bumps, a mild headache and tenderness at the injection site. These occur after a proportion of treatments, are harmless and disappear within days.
Also mild: a feeling of heaviness in the forehead during the first week. That comes from using a muscle that cooperates less than you are used to; you adjust within a few days.
Asymmetry
Faces are never entirely symmetrical, and muscle strength differs between left and right. After a treatment the result can therefore turn out slightly uneven. This is usually straightforward to correct with a small touch-up at the two-week check-up.
That is exactly why we schedule that check-up as standard and include it in the price. Anyone who only raises asymmetry after three months has lived for three months with something that could have been fixed in five minutes.
Drooping eyelid and lowered eyebrow
This happens when the product spreads to a muscle it was not intended for: the muscle that lifts the upper eyelid, or the one that holds the eyebrow high. The chance of this is small and relates to placement, dose and what you do in the first few hours.
It always resolves on its own, because the effect is temporary. For a drooping eyelid, a doctor can prescribe eye drops that engage a small accessory muscle and lift the eyelid by a few millimetres. That is not a cure, but it does bridge the gap.
If you notice this in yourself, contact your doctor. Not because it is dangerous, but because something can be done about it and because it belongs in your record for next time.
Rare and serious
Very rarely, the effect spreads to muscles further away, with symptoms such as difficulty swallowing, speech problems, muscle weakness or breathing difficulties. This calls for immediate medical assessment.
Also rare: an allergic reaction to the product. That too is a reason to make contact straight away.
The chance of this at cosmetic doses is small, but it is exactly why we have only doctors treat: someone who recognises the symptom and knows what needs to happen next.
What a good practitioner does about this
Beforehand: naming the risks in plain language and recording that the conversation took place. During: dosing according to your muscle strength and placing carefully. Afterwards: being reachable, checking after two weeks and recording everything in the file.
A practitioner who does not mention the risks is not offering reassurance. They are selling.
Frequently asked questions
How long does a drooping eyelid last after a wrinkle treatment?
Usually a few weeks to a couple of months, depending on the dose. It always resolves, because the effect of the product is temporary. Eye drops can lift the eyelid by a few millimetres in the meantime.
Can asymmetry be corrected?
Often yes, with a small touch-up at the two-week check-up. With us, that is included in the price.
When should I seek urgent medical help?
With difficulty swallowing, speaking or breathing, with general muscle weakness, or with signs of an allergic reaction. This is rare, but it needs immediate assessment.
Written by Dr Sanne de Boer, doctor at Calla Medical. This article is general information and does not replace personal medical advice; please discuss your own situation during a consultation.
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