Injectables are everywhere. They're on your social feeds, in your group chat, and probably used by more of your coworkers than you realize. [Over 7 million Botox injections and 2.6 million dermal filler injections](https://www.plasticsurgery.org/news/blog/taking-the-mystery-out-of-botox-and-dermal-fillers) are performed in the US each year, making them the most popular minimally invasive cosmetic procedures by a wide margin.
They're also the treatments where the gap between a good provider and a bad one is widest. A skilled injector can produce subtle, natural-looking results with minimal risk. An unskilled one can cause complications that range from bruising to permanent damage.
Here's what we think is worth knowing before you book.
What they actually are
"Injectables" covers two different families of treatments that do different things.
**Botulinum toxin injections.** This includes Botox, Dysport, Xeomin, and Jeuveau. These are [purified neurotoxins](https://facialesthetics.org/patient-info/botox/the-risks-of-botox-and-fillers-what-you-need-to-know/) that temporarily relax muscles by blocking the nerve signals that tell them to contract. They're used primarily to soften dynamic wrinkles, the lines that form when you make expressions like frowning or squinting. Results take about a week to appear and typically last three to four months.
**Dermal fillers.** This is a broader category of gel-like substances that are injected to add volume under the skin. Most modern fillers are made of [hyaluronic acid](https://www.fda.gov/consumers/consumer-updates/dermal-filler-dos-and-donts-wrinkles-lips-and-more), a substance that occurs naturally in the body. Brands include Juvéderm, Restylane, and Belotero. Other fillers use calcium hydroxylapatite (Radiesse) or poly-L-lactic acid (Sculptra) and work by stimulating your body's collagen production over time. Results are often visible immediately and typically last 9 to 18 months depending on the filler and where it's placed.
Botox and fillers do different things and are often used together. They are not the same treatment and shouldn't be discussed interchangeably.
What the research actually says
The research here is well-established. Both Botox and FDA-approved dermal fillers have been studied for decades, and both are considered [safe and effective when administered by qualified practitioners](https://www.yalemedicine.org/conditions/botox-and-soft-tissue-fillers). Side effects from routine cosmetic use are usually mild and temporary: bruising, swelling, redness, or soreness at the injection site.
The bigger risk isn't the product. It's the person injecting it.
What to actually watch for
Serious complications are rare when injectables are performed by qualified medical professionals. They are not rare when performed by untrained practitioners.
The [most serious complication](https://pmc.ncbi.nlm.nih.gov/articles/PMC11745296/) for fillers is vascular occlusion, where filler is accidentally injected into a blood vessel. This can cause tissue death, and in very rare cases, blindness or stroke. A trained medical professional knows facial anatomy well enough to avoid this, and knows exactly what to do if it happens (hyaluronidase can dissolve hyaluronic acid fillers quickly if caught in time).
For Botox, the most common issues are asymmetry, drooping eyelids or brows, or over-treatment that produces a "frozen" appearance. These usually resolve as the product wears off over weeks to months, but they can be distressing in the meantime.
The common thread: both risks are dramatically reduced by picking a provider who knows what they're doing.
How to pick a provider
This is the most important part of this article. Skim everything else if you want. Read this.
**Look for medical credentials.** Board-certified plastic surgeons and dermatologists have the most anatomical training. Registered nurses and physician assistants working under medical supervision are also qualified if they've completed proper injectable training. In most countries, these procedures should be performed in a medical setting, not a spa.
**Ask what emergency protocols they have.** A qualified provider should be able to tell you immediately what they'd do in case of a vascular occlusion or other complication. If they hesitate or don't know, leave.
**Ask what product they use and why.** FDA-approved (or your country's equivalent regulatory approval) is non-negotiable. A good provider will explain why they chose a specific product for your specific treatment.
**Pay attention to the consultation.** A qualified provider will spend time understanding what you want, looking at your face, asking about medical history, and managing expectations. A rushed consultation with pressure to book same-day is a red flag.
**Avoid cheap pricing.** Bargain injectables are almost always a sign of either counterfeit products, unqualified practitioners, or both. This is one of the clearest cases in wellness where paying for expertise is paying for safety.
Before you book
A few things to discuss with your provider during your consultation:
- Any medications you take, especially blood thinners or aspirin - Any allergies, especially to ingredients in local anesthetics - Any history of cold sores (some procedures can trigger outbreaks) - Whether you're pregnant or breastfeeding (both products should generally be avoided during these times) - Any upcoming events, since bruising is possible for several days
Most clinics [recommend avoiding](https://facialesthetics.org/patient-info/botox/the-risks-of-botox-and-fillers-what-you-need-to-know/) blood-thinning medications, alcohol, and strenuous exercise for 24 to 48 hours before and after treatment.
A note on the broader conversation
We're not here to tell you whether to get injectables. The decision is personal, and it's completely legitimate to do them, completely legitimate not to, and completely legitimate to change your mind at any point.
What we care about is that if you do book, you book with someone qualified, in a medical setting, with informed consent and realistic expectations. Good providers do this work well. Less-good providers do damage that can take time and money to fix.