Botox, peels, fillers and dermabrasion

Some cosmetic procedures, such as Botox injections, don't involve surgery  but this doesn't mean they're without risk. Follow these tips to find a qualified and safe practitioner.

Non-surgical cosmetic procedures involve products, such as botulinum toxin (botox), or techniques that make the skin look smoother, or make marks on the skin less obvious. There are also procedures to change the way teeth look, such as making them whiter or straighter.

Non-surgical cosmetic procedures are rarely available on the NHS, so you will usually have to pay for them privately. If you're considering a procedure, find out what it involves, what the risks are and how much it costs. Ask about the qualifications and experience of the person who will be giving it to you, to see if they're appropriately qualified.

You can read the whole of this page, or click on these links to go straight to the relevant information:

What non-surgical treatments are there?

Where can I get a non-surgical procedure done safely?

How can I find out whether the provider is safe?

What are the risks of non-surgical procedures?

Do I need to see a doctor before I can get Botox? 

What if I feel unwell after a procedure?

What non-surgical treatments are there?

There are various procedures available, including:

  • muscle paralysis – such as injections of Botox to relax facial muscles, and make lines and wrinkles less obvious
  • dermal fillers – injected into wrinkles or creases to fill them out
  • chemical peels – which use chemicals to remove the outer layer of skin cells
  • microdermabrasion – which uses fine crystals and a vacuum to remove dead skin cells
  • non-surgical laser and intense light treatments – such as laser hair removal

Some treatments can leave the treated area sensitive or red for days or weeks.

Where can I get a non-surgical procedure done safely?

Procedures such as teeth whitening can be safely carried out in dental clinics. 

Find a dentist near you.

Cosmetic injectable treatments (such as Botox) should only be carried out by an appropriately trained doctor, pharmacist, dentist or registered nurse in a clinical environment. They shouldn't be carried out by beauty therapists who lack the necessary clinical background.  

How can I find out if the provider is safe?

It's important to use a reputable practitioner, who is properly qualified. However, providers of cosmetic treatments that do not involve surgery don't have to be registered with the Care Quality Commission (CQC), which is the independent regulator for health services in England.

The CQC says that you can be at risk of harm from procedures if they're not carried out correctly. It's important to research the procedure, the provider and the person who will be carrying it out.

What are the risks of non-surgical procedures?

"Non-surgical procedures usually involve injections of either fillers or botulinum toxin, and carry less serious risks than surgery in general," says Professor Simon Kay, a consultant plastic surgeon and member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS). "However, over-correction can be difficult to treat, as can asymmetrical placement of the filler and allergic reactions."

He advises asking what can be done if these happen, and discussing allergies and other potential complications of each filler.

"Usually, the manufacturers include patient information leaflets, which should cover these points," says Professor Kay. "Risks can be minimised by choosing a reputable surgeon or an established nurse practitioner who is working in a clinical environment."

Do I need to see a healthcare professional before I can get Botox?

Yes. Prescribers are advised against prescribing cosmetic injectable medication by telephone, fax, video link or online. This means that prescribers must meet with patients face-to-face before prescribing Botox and other injectible cosmetics, such as Dysport or Vistabel, to make sure they fully understand the patient's medical history and reasons for wanting the treatment.

You can read the General Medical Council's guidance on prescribing and managing medicines and devices.

Safety checklist

Sally Taber, who manages the Standards and Training principles for the organisation Treatments You Can Trust, says: "There's no doubt that injectable cosmetics are extremely popular. However, a rapidly growing market such as this often leads to opportunities for bad practice. We urge everyone to think about their safety when choosing a practitioner."

Sally offers a five-point checklist to ensure you get treated by the right kind of person:

  1. Qualifications: Check the qualifications of the practitioner. Only regulated doctors, dentists, pharmacists and registered nurses are appropriately qualified to give injectable cosmetic treatment.
  2. Title: Don't be taken in by unusual or unrecognisable titles, such as "Advanced Aesthetic Practitioner/Therapist". When you check qualifications, make sure that the title of doctor, dentist or registered nurse actually applies to the person who is holding the needle.
  3. Training: Practitioners need training in a variety of areas to give injectable cosmetic treatments. These include how to deal with a severe allergic reaction (anaphylaxis) and other adverse reactions to treatment.
  4. Location: Treatments such as Botox and dermal fillers should only be carried out in a clean, safe and appropriate clinical environment to avoid infection and permanent physical damage. Treatments should not be carried out in a home setting or, for example, in a nail bar or tattoo parlour, but in a clinical facility.
  5. Substance: While Botox is a prescription-only medicine, dermal fillers are not currently treated as such in the UK and can be bought in various outlets, as well as online. While this is legal, Treatments You Can Trust advises people to be extremely careful when dealing with any cosmetic injectables. Some dermal fillers are permanent and can be dangerous in the wrong hands. Treatments You Can Trust recommends that you do not buy cosmetic injectables from the internet.

What if I feel unwell after a procedure?

If you've had a non-surgical procedure and start to feel unwell, get medical help.

"The first priority is health," says Professor Kay. "If you have any alarming symptoms, such as a rash, fever, swelling or increasing pain, go to your GP or your local accident and emergency (A&E) department.

"Less urgent problems should be dealt with by the practitioner who administered the substance or treatment. Your GP only needs to be involved if that avenue fails to resolve the issue."

Page last reviewed: 25/07/2014

Next review due: 25/07/2016


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The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

PennyLane01 said on 17 June 2015

I have to disagree with the comment regarding location of procedures. We carry out many therapies in patients own homes - Haemodialysis, peritoneal dialysis, blood transfusions to name but a few. As a professional who works in an acute NHS hospital setting, as well as carrying out non-surgical aesthetic procedures, it is perfectly acceptable to provide many of these in the home environment. Obviously the practitioner needs to be equipped and proficient in being able to deal with possible complications. Being in a shiney private clinic does not always equate to being cleaner or safer than carrying out procedures elsewhere.

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