Some things people bring to a med spa need a doctor rather than a treatment room. Some things people bring to a med spa are not aesthetic problems and need a doctor rather than a treatment room. See a physician or a dermatologist, not us, if you have a mole or a mark that has changed shape, colour or size, or that bleeds, itches or will not heal; a sore anywhere that has been there more than three weeks; a rash you cannot explain; a patch of skin that is newly numb, hard or ulcerated; sudden hair loss in patches, or hair loss alongside fatigue or weight change; or swelling, heat and spreading redness that could be an infection. And if you have had filler treatment anywhere and the area becomes white or mottled, severely painful, or your vision changes, that is an emergency — telephone us immediately if we treated you, and go to an emergency room if you cannot reach somebody within minutes. We would far rather you rang a doctor and never rang us at all.
The risks, plainly. Every treatment on this site has side effects and some carry real risks. The common ones are minor and short-lived — redness, swelling, tenderness, bruising, a day or two of looking like you have had something done. The uncommon ones matter more: burns, blistering and long-lasting pigment change from light-based treatment, which is a greater risk on deeper skin tones and on recently tanned skin; infection anywhere the skin is broken; and lumps, asymmetry and, very rarely, a blocked blood vessel from injectable filler, which is the one true emergency in this field. We screen for what makes each of these more likely, we tell you your own risk rather than the average one, and we decline to treat when the answer should be no.
By family
What can go wrong, and how likely it is
Six categories. The second one is the reason injectable treatment should never be performed by somebody who cannot manage a complication, and the sixth is the one that is really about where you choose to be treated.
Injectables — the common problems
Bruising, swelling, tenderness, small lumps, and asymmetry that usually settles or is corrected at the two-week review. Roughly a third of filler treatments bruise, more with lips and more in anybody taking something that thins the blood. Expected, self-limiting, and worth planning around if you have something on next weekend.
Injectables — the emergency
Product entering or compressing an artery blocks the blood supply to the skin it feeds, and because some facial arteries connect back toward the eye, in very rare cases vision is affected. It presents as severe pain out of proportion, skin that goes white and then mottled or dusky, and any visual change. We hold what is needed to reverse it on site on every treatment day, and hours matter. This is the reason we do not perform non-surgical nose treatment at all.
Light-based treatment — burns and pigment
Blistering, burns and long-lasting pigment change, almost always the result of too much energy for the skin in front of the device or of treating recently tanned skin. Richer skin tones carry a higher risk. Managed with the right wavelength, conservative settings and a free test patch reviewed two weeks later — two weeks, because a burn shows immediately and pigment change does not.
Skin treatment — depth and infection
A peel taken deeper than the skin has been prepared for, an infection where the skin was broken, a cold sore provoked by facial treatment, or post-inflammatory darkening in the weeks afterwards. Prevented by preparation, by antiviral cover where there is a cold sore history, by correct depth, and by leaving peeling skin alone rather than pulling it.
Body treatment — the uncommon one
Cryolipolysis carries a small risk of paradoxical fat growth: the treated area enlarging rather than shrinking, months later, forming a firm mass in the shape of the applicator, which needs surgery to correct. It is uncommon and it is real, and you should hear about it before agreeing to treatment rather than in a consent form in the room.
Everything — the risk nobody lists
Being treated by somebody who cannot manage what they are doing when it goes wrong. Injectables and medical lasers are available in a great many places with no medical oversight, no consultation and no plan for a complication. The price is usually the giveaway, and the question that separates them is: what would you do if this went wrong, and do you hold what is needed here?
Recognise this
The filler emergency, in four sentences
If you have had filler anywhere and any of the following happens, telephone immediately. It is uncommon, it is treatable, and how quickly it is treated decides whether it leaves a mark.
- Pain that is severe, out of proportion, and getting worse rather than better
- Skin that goes white, then mottled, dusky or blue-grey
- Any change in vision at all, however slight
- Numbness, or a headache, alongside any of the above
Ordinary swelling and ordinary bruising are neither of those things and are an expected part of the treatment. If you are unsure which you are looking at, that is exactly what the telephone number on your written plan is for, at any hour. We would far rather have twenty calls about a normal bruise than miss one that was not.
How we reduce it
Screening, settings and saying no
A medical history that is actually read
Your medication, your health, your history of scarring or cold sores, what you have had done before and when, and what you are planning in the next three months. Most preventable complications are prevented here rather than in the treatment room.
Test patches, free, reviewed at two weeks
For any light-based treatment where skin type, a recent tan or a history gives reason to be careful. Two weeks rather than two days, because a burn shows immediately and pigment change does not.
Conservative settings, escalated across a course
Rather than starting at the setting that produces the fastest result. It costs an extra session and it removes most of the injury risk in this field.
Declining, which we do regularly
Over a fortnight-old tan, over an undiagnosed skin change, during pregnancy, for anybody under eighteen wanting cosmetic injectables, and for anybody whose expectations the treatment cannot meet. /contraindications.html is the list in full.
Aesthetic treatment is elective medicine, and this page is not medical advice for you. Aesthetic treatment is elective, it is medicine wherever it breaks the skin, and nothing on this website is medical advice for you in particular. We do not diagnose disease. Every treatment here begins with a consultation and a medical history, because your health, your medication, your skin type and what you have had done before all change what is safe and what is sensible. Some people are told no. Being told no is a normal outcome of a consultation here rather than a failure of one, and it costs exactly the same as being told yes.
Questions
Safety — the questions we are asked most
How dangerous is any of this really?
Serious harm is uncommon and it is not rare enough to ignore. Most of what happens is bruising, swelling and disappointment. The events that matter — a blocked vessel after filler, a burn or lasting pigment change after light-based treatment, an infection where the skin was broken — are uncommon, they are largely preventable by screening and technique, and they are the reason this is medicine rather than beauty.
What is the single most serious thing that can happen?
A blocked blood vessel after filler injection. It threatens the skin that vessel supplies and, very rarely, vision. It is recognisable — severe pain out of proportion, skin going white then mottled, any visual change — and it is treatable if recognised quickly, which is why every client here leaves able to describe it and with a number that is answered out of hours.
Is light-based treatment riskier on darker skin?
Yes, and pretending otherwise is how people get hurt. Light is absorbed by pigment, so on richer skin more energy goes into skin rather than into the target, and the risk of burns and long-lasting pigment change rises. It is managed with the right wavelength, conservative settings and a test patch — and for one treatment on this site, intense pulsed light, it is managed by not offering it.
What makes a complication more likely?
A recent tan, more than anything else. Then: an undisclosed medication, a treatment taken deeper than the skin was prepared for, an untreated cold sore history, treatment during an illness, and a practitioner working faster than they should. Almost every item on that list is prevented by a consultation somebody actually took seriously.
What should I do if something looks wrong?
Telephone us, at any hour, on the number on your written plan, and speak to the person who treated you. Do not wait until the morning and do not go to a pharmacy for advice. For severe pain, skin colour change or any change in vision after filler, telephone immediately and go to an emergency room if you cannot reach somebody within minutes.
Will I be charged for fixing a problem?
No. Nobody is charged for the management of a complication we caused, including the medication used to reverse a filler emergency and every follow-up appointment involved. That is not generosity; it is the minimum, and any clinic that charges for it is telling you something about itself.
A written plan and a written price before anything is booked
Book a consultation
Pick a clinician and an hour from the calendar — it shows only the times each of them genuinely has free. A consultation is a full hour at a table with no treatment couch in the room, and it costs $85, or $120 with the medical director. If you go ahead, that comes off your first treatment. If we tell you the answer is nothing, or a dermatologist, it costs exactly the same.