Are Anti-Wrinkle Injections Safe?

Safety is the most important consideration for anyone thinking about having anti-wrinkle injections, and it is entirely right to ask the question. The good news is that when administered by a qualified and experienced practitioner using licensed products in a regulated clinical environment, muscle relaxant injections have an excellent safety record built over decades of both medical and cosmetic use. However, the safety of this treatment is not unconditional — it depends fundamentally on who is performing it, where, and with what products. This guide aims to give Edinburgh patients a clear and honest picture of what is involved.

Muscle relaxant type A has been used in medicine for several decades, initially for therapeutic purposes such as treating muscle spasticity, hyperhidrosis (excessive sweating), chronic migraine, and certain eye conditions. Its cosmetic applications have built on this long history of medical use, and the safety data accumulated over many years of both clinical and aesthetic practice is extensive and well-established. The NHS provides detailed guidance on muscle relaxant injections for patients considering cosmetic treatment — their full information page is available at nhs.uk.

What Makes Anti-Wrinkle Injections Safe When Done Well?

Several features of muscle relaxant treatment contribute to its strong safety profile when administered correctly by a qualified practitioner:

• Highly localised effect: When correctly administered, muscle relaxant acts locally on the specific muscles into which it is injected. It does not spread significantly through the body, and systemic effects are extremely rare at the doses used for cosmetic treatment.
• Temporary and reversible: The effects are not permanent. The body naturally breaks down the protein over a period of weeks and months, and full muscle activity returns. If something does not look right, it will resolve as the product wears off.
• Decades of clinical evidence: Muscle relaxant has been studied and used in clinical medicine since the 1970s. The cosmetic applications have added further layers of evidence and real-world experience over the past thirty years.
• Licensed products with known safety standards: In the UK, only a small number of muscle relaxant products are licensed for cosmetic use, and reputable practitioners use only these licensed brands, which are manufactured to consistent pharmaceutical standards.

What Are the Possible Side Effects?

Like any medical treatment, anti-wrinkle injections carry the possibility of side effects, though the majority are mild and temporary. Understanding these in advance helps you manage your expectations and know what to look out for after treatment.

Common, minor side effects include:

• Redness, mild swelling, or bruising at the injection sites — usually resolving within hours to a few days
• A mild headache following treatment, typically resolving within 24 hours
• Temporary tenderness or sensitivity in the treated area
• Small pinprick marks at the injection sites that resolve quickly

Less common but more noteworthy side effects include:

• Drooping eyelid (ptosis): If muscle relaxant migrates to the levator palpebrae muscle, which lifts the upper eyelid, temporary drooping can occur. This is rare when injections are placed correctly by an experienced practitioner, and it resolves naturally as the product wears off — typically within two to four weeks.
• Asymmetry: Uneven results can occur, particularly in first-time patients or in areas where facial muscle anatomy varies significantly from one side to the other. Minor asymmetry can usually be addressed with a small additional injection at the two-week follow-up appointment.
• Brow heaviness: If the dose in the forehead is too high or placed too low, it can sometimes create a feeling of brow heaviness or a slightly flat-looking forehead. This resolves as the product fades.
• Flu-like symptoms: A small number of patients report feeling mildly unwell — fatigued or slightly achy — in the day or two following treatment. This is uncommon and brief.

Serious Complications and How They Are Avoided

Serious complications from cosmetic muscle relaxant treatment are rare but do occur, almost always in association with inadequate practitioner training, unlicensed products, or inappropriate administration. The most significant risk is the spread of muscle relaxant beyond the intended treatment area, which in rare cases can cause difficulty swallowing, speaking, or breathing. These events are associated with the use of unlicensed products, excessive doses, and deeply placed injections in areas not appropriate for cosmetic treatment.

This is precisely why choosing a qualified, regulated healthcare professional for anti-wrinkle injections is not an optional preference — it is a fundamental patient safety consideration. A dentist or doctor performing facial aesthetics brings both the anatomical knowledge to place injections precisely and the clinical training to recognise and manage complications if they occur.

The Risk of Unregulated Providers

A significant and growing proportion of adverse events associated with anti-wrinkle injections in the UK arise from treatment carried out by untrained or inadequately trained providers. The growth of the aesthetics market has unfortunately attracted some providers who offer injectable treatments after completing only minimal training, and sometimes using unbranded or unlicensed products purchased from unregulated sources.

In the UK, muscle relaxant is a prescription-only medicine. It can only legally be prescribed following a face-to-face assessment by a qualified prescriber — a doctor, dentist, pharmacist prescriber, or nurse prescriber. Any person advertising anti-wrinkle injections who does not require a proper consultation with a prescriber before administering the treatment is operating outside the law. Patients who are offered treatment without this step should seek care elsewhere.

Who Should Not Have Anti-Wrinkle Injections?

There are certain circumstances in which anti-wrinkle injections are not appropriate. These include:

• Pregnancy and breastfeeding
• Known allergy to muscle relaxant or to any component of the product (including human albumin)
• Neuromuscular conditions such as myasthenia gravis, Lambert-Eaton syndrome, or motor neurone disease
• Active infection in or close to the intended treatment area
• Certain antibiotics, particularly aminoglycosides, which can potentiate the effect of muscle relaxant
• Blood-clotting disorders or use of anticoagulant medications (not an absolute contraindication but requires careful management)

A thorough pre-treatment consultation will identify any contraindications before treatment is offered. Skipping this step is never appropriate.

Safety Profile Summary

Risk Category	Example	Frequency	Outcome
Minor (very common)	Redness, bruising, swelling at injection sites	Common	Resolves within days
Minor (uncommon)	Mild headache, flu-like feeling	Uncommon	Resolves within 24–48 hours
Moderate	Asymmetry, uneven result	Uncommon	Adjustable; resolves naturally
Moderate	Eyelid drooping (ptosis)	Rare with skilled injector	Temporary; resolves as product wears off
Serious	Distant spread of toxin	Very rare; linked to unlicensed product	Seek urgent medical attention

What to Do If You Experience a Problem After Treatment

Despite all the precautions that a competent practitioner takes, it is important for patients to know what to do in the unlikely event that something does not seem right after their treatment. Minor redness, swelling, and bruising are expected and not a cause for concern. However, certain symptoms warrant prompt attention:

• Significant swelling or redness that worsens rather than improves over the first few days
• Pain that is disproportionate to what was expected
• Skin that appears white, mottled, or significantly discoloured following injection — this can indicate vascular compromise and requires immediate contact with your practitioner
• Any difficulty swallowing, speaking, or breathing following muscle relaxant treatment — seek emergency medical attention immediately
• Signs of infection such as increasing warmth, pus, or fever

Your practitioner should always provide you with clear aftercare information and contact details before you leave the clinic. A reputable provider will have an out-of-hours emergency contact available for genuine complications. At Gorgie Road, we take our aftercare responsibility seriously and ensure every patient knows exactly who to contact and what to do if they have any concerns after treatment.

The Role of Informed Consent

Proper informed consent is a fundamental ethical and legal requirement before any aesthetic treatment. This means that before you agree to proceed, you must be given clear, honest information about what the treatment involves, what results are realistically achievable, what the risks are, and what alternatives exist. You must have the opportunity to ask questions and have them answered fully, and you must be free to decline or withdraw consent at any time without pressure.

Rushing the consent process, providing consent forms only on the day of treatment without prior discussion, or using high-pressure sales techniques to encourage a booking are all concerning practices that fall below the ethical standard expected of healthcare professionals. At Gorgie Road Dental Practice, informed consent is taken seriously as a process rather than simply a form to be signed — it is an ongoing conversation throughout your treatment journey.

Your Safety Is Our Priority

At Gorgie Road Dental Practice, patient safety is our highest priority in everything we do. Our team are fully qualified healthcare professionals registered with the General Dental Council, and we carry out all anti-wrinkle injection treatments in our regulated clinical setting using only licensed muscle relaxant products from reputable manufacturers. We always conduct a thorough face-to-face consultation before any treatment and are fully equipped to manage any complications should they arise. If you have questions about the safety of anti-wrinkle injections or would like to book a consultation in Edinburgh, please call us on 0131 337 3936.