Patient Safety in Non-Surgical Facial Aesthetics: A Systematic Review of Adverse Events, Regulatory Environment and Clinic-Level Protocols

Non-surgical facial aesthetic procedures — predominantly botulinum toxin and hyaluronic acid (HA) dermal filler injections — are among the fastest-growing medical interventions worldwide. The volume of treatments delivered each year now far exceeds the volume of robust safety data collected about them. Reported rates of adverse events vary by more than two orders of magnitude between studies, jurisdictions and practitioner groups, and the most catastrophic events — vascular occlusion, blindness, stroke, necrosis — remain disproportionately attributable to a small number of recurrent, often preventable failure modes.