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    Fillers and Botox - How Can It Go Wrong?

    Embark on an insightful journey into the world of cosmetic enhancements with our in-depth exploration of the potential challenges associated with fillers and Botox as we sit down with Dr Ahmed El Muntasar, an NHS frontline doctor and award-winning celebrity aesthetic practitioner.


    Delve into the intricacies of these popular procedures, gaining valuable insights into the risks and complications that can arise. From managing expectations to understanding the crucial role of qualified practitioners, this article provides essential information for both seasoned enthusiasts and newcomers alike.

    By Sophie Bronstein / Jan 12 2024

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    You only have to take a quick scroll through your Instagram feed to see that facial ‘tweakments’ – like Botox and dermal filler – have become the new normal. And although here at Dandy we are all for embracing natural beauty and proudly ageing gracefully, there’s no getting away from the fact that according to statistics, over 6.2milion Botox injections were administered worldwide in 2021 alone.**. And considering that we have been raised in a society that has conditioned us to nit-pick our ‘flaws’, this doesn’t come as a surprise.


    But while the freedom of choice and autonomy over one’s own body has never been more important, it is absolutely crucial to make educated decisions before you take the plunge to go through an injectable procedure. 


    Why? Well, in short, there are so many ways in which it could go shockingly wrong.  


    After speaking with Dr Ahmed El Muntasar, an NHS frontline doctor and award-winning celebrity aesthetic practitioner, we realised that there are a lot of things to consider when making decisions related to non-surgical cosmetic procedures. He told us exactly what we needed to know…

    what can go wrong if botox and dermal fillers are administered incorrectly?

    “When Botox goes wrong, the possible complications are usually related to appearance. If it is injected too low in the forehead, the eyebrow can drop, causing ‘ptosis’ – meaning that the forehead has been relaxed too much causing the brow to drop. 


    This can cause trouble with blinking. If a person can’t blink, they can’t lubricate the top surface of the eye – the sclera – which can lead to dry eyes and possibly increase their chances of corneal ulcers. 


    If too much Botox is injected into the master muscles, it can cause someone’s appearance to become disproportionate and affect the movement of the mouth. When it comes to fillers, if anything is injected incorrectly, it can migrate to the wrong place. Some more serious complications of this include blood vessel blockage. For areas like the nose, which has many blood vessels, this can cause severe irreversible issues such as blindness.”


    are there any warning signs to look

    “After treatment, swelling, bruising, pain or things temporarily looking a bit a-symmetrical or bumpy are normal. 


    However, if the skin is cold and mottled, or if you press on the skin for five seconds and the skin does not return to its normal colour within a few seconds, it means the blood supply has been compromised. This is called the ‘capillary refill effect’. 


    If the capillary refill is more than two seconds, then urgent medical attention should be sought. The second you feel like something might be wrong, that alone is a good enough reason to contact your doctor and get reviewed immediately.”

    who should be avoiding botox and filler treatments?

    “You should ALWAYS have a consultation process with your injector before your session. This is the best way to know if you are suitable for the procedure or not. 


    In general, people that should steer clear of Botox are those with muscle disorders such as Myasthenia gravis – an autoimmune condition that causes weakness of the muscles. 


    If you suffer with bleeding or clotting disorders, you should also avoid fillers and Botox, and those that are on blood-thinning medication should also be cautious. If you have had surgery – for example rhinoplasty – you need to find someone who is an expert in this field, as your anatomy changes after surgery and you are at a much higher risk of something going wrong.”

    what qualifications or insurance should we look for when looking for a reliable aesthetician?

    “Your injector needs to be a qualified medical professional – namely a medical doctor, a dentist or a prescribing nurse. A lot of people are able to get insured to practice. However, someone just saying that they are ‘fully insured’ on their Instagram doesn’t hold much weight. 


    This is because a lot of the cheaper insurance companies will insure non-medics, but if something does go south, there isn’t much that is actually covered by their policies. However, there are more expensive companies who offer policies to trained professionals and provide proper cover should anything go wrong.”

    how can we find a reliable, educated, full insured + qualified aesthetician?

    In February of this year, the UK government announced that it intends to crack down on aestheticians that do not have the correct qualifications by introducing a ‘licensing regime’. 


    This means that anyone offering Botox or fillers are now required to have a license, and anyone who doesn’t will be committing a criminal offence. The bill was introduced as a result of rising ‘botched’ non-surgical cosmetic procedures, and will require all practitioners to meet certain qualification, hygiene and safety standards. 


    There is also a new directory service,, which is a platform on which anybody wanting non-surgical cosmetic procedures can browse for a fully qualified, insured and licensed aesthetician. It will also act as a hub for members to discuss any concerns they may have and to gain support for any issues that they may be facing. 



    In our view, every woman is perfect just the way she is. Every lump, bump, spot, freckle, wrinkle and stretch mark tells a story - and a beautiful one at that! Loving yourself starts from within, and we encourage each and every woman to embrace their natural beauty. 


    BUT, if you’re considering going for a procedure, we hope that you are now armed with the important information you need to proceed. Still not sure? Click here to check out the girls who are redefining perfection, getting rid of stigmas and helping us to feel more beautiful in the skin we’re in – one ‘flaw’ at a time! 

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