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5 Botox Side Effects You Should Know

By SL Aesthetic Clinic
Last Updated:
December 4, 2024

With millions of Botox treatments performed annually, Botox is one of the most sought-after cosmetic procedures in the world. With Botox prices in Singapore ranging from a few hundred to thousands of dollars for differing treatments, there’s a treatment designed for everyone.

Many seek Botox almost instinctively to look younger. But what is it about this sought-after treatment we should know? As it turns out, there are plenty.

Before you join millions of Botox fans around the world, here’s what you should know about Botox and its side effects.

Here, we will list 5 Botox side effects; from the most common such as the temporary freezing of facial expressions, before delving into management and preventive tips for these side effects.*

Note: Botox is a brand name and often used synonymously with the neurotoxin botulinum toxin. In this article, we will be using the term ‘botox’ to refer to botulinum toxin.

A Quick Guide to Botox

Botox is a neuromodulator. This means it blocks nerve signals. In cosmetic use, Botox is typically injected into muscles to weaken muscular activity. The drug is predominantly used to reduce and prevent skin wrinkling from muscle movement.

Generally, although Botox in Singapore injections are relatively safe, some minor side effects can occur.

1. Inflammation & infection

These side effects are minor and can occur in any medical treatment that is invasive in any degree, including injectables. They happen when wounds become infected by bacteria.

Board-certified medical practitioners are called as such because they meet the minimum standards as expected of them. One of which is a good standard of hygiene, which can prevent inflammation or infection from taking place.

2. Fever, headache, and chills

Although rare, some patients react to Botox adversely. This immune response can manifest in fevers, headaches, and chills. These reactions tend to be isolated cases and vary by the individual. For example, a patient can have an allergic response to Brand A of botulinum toxin but experience none when treated with Brand B.

3. Pain, tenderness, bleeding, swelling, and bruising

These side effects come with any medical treatment to some degree.

In Botox treatments in Singapore, pain is very minimal due to its use of very short and fine needles. Of course, this will depend on the individual’s pain tolerance.

And because of its needle size, very little bleeding will occur, if any. Unless of course, the patient has a blood clotting disorder or had imbibed alcohol or painkillers before treatment.

Swelling is an immune response from the body as it recognises there’s trauma or an open wound.

Bruising with Botox treatments is very minimal as the needles are short and typically do not go deep enough into the skin to cause damage to blood vessels.

4. Temporary Side Effects Around The Eyes

Botox can be used to lift hooded eyes, lift the brows and soften a frown.

Botox treatments of the eyes involve expert manipulation of the push and pull muscles around the eyes. In a brow lift, for example, the doctor uses Botox to create a slight imbalance between these muscles by weakening certain muscles, creating a lift or a drop of the brow.

And because the skin around the eyes is the most delicate on the face, any misplaced injection or miscalculated number of units can cause very visible side effects.

These include droopy eyelids, uneven eyebrows, dry eyes or excessive tearing, and the “classic” surprised look.

However, these side effects generally subside once the Botox wears out over a period of 3 to 4 months.

5. Crooked Smile and Drooling

Sometimes, Botox can also be used in novel applications such as the Nefertiti Lift. In this treatment, the goal is to achieve a cleaner, less wrinkled neck by injecting the drug along the jawline.

The Nefertiti Lift is an advanced treatment with a higher risk of complications such as a crooked smile, or even drooling. It should be performed by a more experienced doctor who’s familiar with facial anatomy.

How long do Botox side effects last?

Most Botox side effects are short-lived and resolve within a few days. Common effects such as bruising, mild swelling, or headaches usually subside within 24-72 hours.

For more uncommon effects like droopy eyelids or uneven results, the side effects may last several weeks but generally resolve as the Botox wears off, which can take 3 to 6 months. If symptoms do not improve, follow up with your practitioner.

Can Botox side effects be permanent?

Botox side effects are usually temporary and resolve as the neurotoxin naturally wears off. However, in extremely rare cases, complications such as muscle weakness or nerve damage can persist longer than expected. This occurs if Botox spreads to unintended areas, often due to incorrect injection techniques. Such effects are expected to improve over time and permanent side effects are rare.

What should I do if I experience side effects?

If you experience mild side effects like bruising or swelling, these can often be managed with simple home care:

  • Cold compress: Press an ice pack to the treated area can reduce swelling and discomfort.
  • Avoid massaging: Refrain from rubbing the treated area to prevent the Botox from spreading to other muscles.
  • Stay upright: Avoid lying down for the first few hours after treatment to minimise the risk of Botox migration.

If you experience more concerning side effects after Botox injection, such as prolonged drooping, muscle weakness, or signs of infection, contact your practitioner promptly. They may offer remedies like eye drops for drooping eyelids or additional treatments to alleviate discomfort.

When to Seek Medical Help

While Botox’s side effects are temporary and typically mild, there are instances when you should seek medical attention. These include:

  • Allergic reactions: Face, lips, or throat swelling, difficulty breathing, or hives are signs of allergy and require immediate medical attention.
  • Severe muscle weakness: If you experience significant muscle weakness, difficulty swallowing, or trouble breathing, this could indicate that Botox has spread beyond the treatment area and requires urgent medical care.
  • Infection: If the injection site shows signs of infection, such as redness, swelling, pus, or warmth, contact your healthcare provider.
  • Prolonged drooping: Eyelid or eyebrow drooping that persists for several weeks should be assessed by your practitioner.

How to Minimise the Risk of Side Effects

Minimising the risk of Botox side effects starts with choosing a qualified and experienced practitioner. Here are additional steps you can take:

  • Choose a licensed practitioner: Ensure your provider is a qualified practitioner with experience administering Botox.
  • Follow pre-treatment instructions: Avoid alcohol, smoking, and blood-thinning medications (like aspirin or ibuprofen) for 24-48 hours before your procedure to minimise bruising and swelling.
  • Post-treatment care: Follow your provider’s aftercare advice closely. Avoid rubbing the treated area, strenuous exercise, or lying down for at least four hours after the procedure to prevent the spread of Botox to unintended muscles.
  • Honest medical history: Disclose your full medical history, including any medications, allergies, or past surgeries, so your practitioner can assess if Botox is right for you.

Botox in Singapore

A very serious allergic reaction to Botox is rare. However, always get medical help immediately should you notice any symptoms of a serious reaction, such as the swelling of the face, tongue, throat, rash, dizziness, or trouble breathing.

Serious Botox side effects such as slurred speech, difficulty in swallowing, breathing, impaired vision, and loss of bladder control can occur hours to weeks after treatment. These, however, are more likely to happen in patients who have Botox treatments in higher doses for therapeutic reasons rather than cosmetic reasons.

Therapeutic treatments include correction of overactive bladder, chronic migraines, uncontrollable blinking, uncontrollable muscle contractions in the neck and shoulders, severe underarm sweating etc.

To avoid such unfortunate situations, please do your research before you visit a clinic. The best aesthetic clinics in Singapore will be happy to answer all your queries about their procedures. After all, it is your face and they want only the best for you. Book an appointment now.

[18 Aug 2019] A blog post by Dr. Gabriel Wong

Medical Aesthetic Doctor
Dr. Gabriel Wong – Photographer Enthusiast
MBBS, Singapore

Having graduated from the Yong Loo Lin School of Medicine – Dr Gabriel Wong worked in several hospitals in Singapore where he honed his medical acumen.

Fate was at work when he met Dr Kelvin Chua, which sparked his interest in aesthetic medicine.

Growing from strength to strength under the tutelage of Dr Chua, Gabriel developed an eye for detail and beauty – perfectly in tune with aesthetic medicine, a confluence of art and science.

He applies this in a range of non-invasive procedures such as Botox treatments, soft tissue augmentation (Dermal Fillers with the Cannula Method), skin rejuvenation with lasers (Fotona5D Laser Lift), and effective acne and acne scar treatments (Fractional CO2 Laser, subcision).

In his free time, Gabriel loves to travel in search of that perfect snapshot. His works of art have won praises by many patients.


For more information, write to contact@slclinic.com.sg.
To contact Dr Gabriel Wong, write to gabriel@slclinic.com.sg.

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