If something goes wrong
Written to be read quickly by someone who is worried. The urgent items are first.
Urgent, meaning now: severe pain or pain out of proportion, blanching, mottling or a dusky or white appearance of the skin, any change in vision, difficulty breathing, or swelling of the lips, tongue or throat. Difficulty breathing or throat swelling is a 999 call. Visual change or severe pain after facial injection needs immediate contact with your practitioner and, if you cannot reach them, an emergency department.
Needs attention today or tomorrow: increasing pain after the first day, spreading redness with warmth, fever, discharge, or swelling that is getting worse rather than better. Contact your practitioner. If you cannot reach them, NHS 111 online will direct you.
4.5.1Now
Call 999 if there is difficulty breathing, swelling of the tongue or throat, or a widespread reaction with faintness. This is the presentation of anaphylaxis and it is a medical emergency. The NHS page on anaphylaxis describes it, and if adrenaline auto injectors are available they should be used according to the instructions while help is on the way.
Contact your practitioner immediately, and go to an emergency department if you cannot reach them, if there is any change in vision after injection near the eye, or if there is severe pain, pain out of proportion to what you were told to expect, or blanching, mottling or a dusky appearance of the skin. This is the presentation associated with vascular occlusion. It is time critical. Do not wait to see whether it settles, and do not accept an appointment in a few days.
4.5.2Today or tomorrow
Contact your practitioner if any of the following develop. If you cannot reach them within a reasonable time, use NHS 111 online, which will direct you to the right level of care.
- Pain that is increasing rather than settling after the first day.
- Redness that is spreading, with warmth, particularly with fever or feeling generally unwell. This is the presentation of a spreading skin infection.
- Discharge or a collection at an injection site.
- Swelling that is worsening after several days rather than settling.
- A lump that is painful, hot or growing.
4.5.3If you cannot reach your practitioner
This happens, and it is the single most common failure in this sector. Treatments are provided in settings without out of hours cover, by people who are not contactable at the weekend, and the patient is left with a problem and no route.
The NHS is the route. NHS 111 online will assess and direct. A general practice can assess an infection. An emergency department is the right place for severe pain, visual symptoms or a systemic reaction. NHS staff will treat you and will not lecture you about having had a cosmetic procedure, and you should not delay because you are embarrassed. Delay is the thing that turns a manageable problem into a serious one.
Take with you, if you can: the name of the product, the manufacturer, the batch number if you have it, the date, the areas treated, and the name of the practitioner. This is why keeping your own record at the time is worth the two minutes it takes.
| What is happening | How urgent | Who to contact |
|---|---|---|
| Difficulty breathing, throat or tongue swelling, faintness | Emergency | 999 |
| Any change in vision after injection near the eye | Emergency, time critical | Practitioner immediately; emergency department if unreachable |
| Severe or disproportionate pain, blanching, mottling, dusky skin | Emergency, time critical | Practitioner immediately; emergency department if unreachable |
| Spreading redness, warmth, fever | Same day | Practitioner; NHS 111 if unreachable |
| Increasing pain after the first day | Same day | Practitioner; NHS 111 if unreachable |
| Discharge at an injection site | Same day | Practitioner; NHS 111 if unreachable |
| Swelling worsening after several days | Within a day or two | Practitioner |
| A lump that is not settling but is not painful | Routine | Practitioner, then clinical assessment |
| Unhappy with the result | Not urgent | Practitioner, in writing; then complaints procedure |
| Misled by advertising | Not urgent | ASA, and consumer advice |
General escalation guidance. It is not a substitute for clinical assessment and it does not replace advice from a clinician who has examined you.
4.5.4Afterwards: complaints and reporting
These are three different things with three different purposes, and it helps to keep them separate.
Resolving it with the clinic
Put your concern in writing, factually, with dates. Ask for their complaints procedure. Ask for a copy of your treatment record, which you are entitled to. Keep copies of everything.
Reporting to a regulator
If the practitioner is on a professional register, that regulator handles concerns about the individual's fitness to practise. Doctors are regulated by the General Medical Council, nurses and midwives by the Nursing and Midwifery Council, dentists and dental care professionals by the General Dental Council, pharmacists by the General Pharmaceutical Council, and various other professions by the Health and Care Professions Council. Each register is public and searchable, and each has a route for raising a concern.
If the practitioner is on no register, there may be no professional regulator to approach, which is one of the more consequential facts about the current position in England and is covered in the regulation chapter.
Reporting the product
The MHRA Yellow Card scheme takes reports about medical devices from members of the public. This is not a complaint about a person and it will not resolve your problem. It contributes to surveillance data that currently barely exists, which is the reason nobody can quote a complication rate.
4.5.5If the problem is what you were told
If the issue is that the treatment was advertised or described in a way that misled you, that is a different route again. The Advertising Standards Authority handles complaints about advertising, including on clinic websites and social media, and its rulings are published. Consumer protection law also covers misleading commercial practices, and Citizens Advice publishes accessible guidance on consumer rights in relation to services.
4.5.6Keeping a record from here
From the moment you have a concern, write things down. Dates, symptoms, photographs with the date visible, what you were told and by whom, and what you did. Photographs taken in consistent lighting are particularly useful because swelling and colour change are hard to describe and easy to dispute.
This is not about building a case. It is that recollection of a stressful period is unreliable, and a contemporaneous record helps whoever assesses you clinically as much as it helps you afterwards.
4.5.7What not to do
- Do not wait to see whether severe pain or a visual change settles.
- Do not accept an appointment several days away for something urgent.
- Do not treat an infection yourself with leftover antibiotics or with products bought online.
- Do not let embarrassment about having had a cosmetic procedure delay you from seeking NHS care.
- Do not agree to further treatment to correct a problem before the problem has been assessed and understood.
That last one deserves emphasis. Being offered more treatment as the immediate response to a complication, before anyone has established what the complication is, is a pattern worth resisting.
Questions
What is the one thing I should not ignore?
Severe pain, pain out of proportion to what you were told to expect, blanching or mottling of the skin, or any change in vision. These are the presentation associated with interruption of blood supply, it is time critical, and waiting to see whether it settles is the wrong response.
My clinic is closed and I am worried. What do I do?
Use the NHS. NHS 111 online will assess and direct you, a general practice can assess an infection, and an emergency department is right for severe pain, visual symptoms or a systemic reaction. Do not delay out of embarrassment about having had a cosmetic procedure.
What information should I take with me?
The product name and manufacturer, the batch number if you have it, the date, the areas treated and the name of the practitioner. This is why writing it down at the time is worth the two minutes.
Who do I complain to?
Start with the clinic in writing and ask for their complaints procedure and a copy of your record. If the practitioner is on a professional register, that regulator handles concerns about the individual. If they are on no register, there may be no professional regulator to approach, which is covered in the regulation chapter.
Should I let them fix it?
Not before anyone has established what the problem is. Being offered further treatment as the immediate response to a complication, before it has been assessed and understood, is a pattern worth resisting.
- NHS 111 online
- NHS, Anaphylaxis
- NHS, Cellulitis
- MHRA Yellow Card scheme
- General Medical Council
- Nursing and Midwifery Council
- Advertising Standards Authority
- Citizens Advice
Links to regulators, professional bodies, legislation and research indexes. They are cited because they are public and checkable, not as endorsement of this publication. No source listed here has any commercial relationship with us.
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