Warning signs after filler.

Normal in the first days: swelling, tenderness, small bruises, mild redness at the injection sites, temporary asymmetry, a feeling of 'too much' in the lips. This subsides within three to seven days, bruises in up to two weeks.

Emergency – vascular occlusion: severe, persistent pain out of proportion to the treatment; whitish or mottled bluish discolouration of the skin, often in an area beyond the injection site; later dark patches or blisters. With visual disturbance, eye pain or double vision call emergency services or an eye hospital immediately. A vascular occlusion must be treated with hyaluronidase within hours. Contact the practice at once – that is what the emergency number is for.

Infection: increasing redness, warmth, swelling and pain after day two to three, possibly fever or pus. Needs medical assessment and usually antibiotics – don't wait.

Allergic reaction: itching, hives, pronounced swelling beyond the area, shortness of breath. With shortness of breath call 112 immediately. True allergies to hyaluronic acid are very rare; reactions to anaesthetic or plasters are more common.

Late effects (weeks to months): lumps, a bluish tinge under the skin (Tyndall effect), delayed swelling after infections. Not an emergency but a reason to come for a check – usually well correctable.

Basic rule: if in doubt, call. Better once too often than once too late. The practice does not resent a question – and a physician who injects fillers always has hyaluronidase in stock.