Beginner-friendly guide to cosmetic injectables

Just because injectables are popular doesn’t mean they come without risks. In fact, an inadequate provider, product, or misunderstanding the treatment can lead to serious complications.

Using cosmetic injectables is a medical procedure and should be treated like one – it’s important to get the right advice from a registered health professional (registered with Ahpra, the Australian Health Practitioner Regulation Agency) who is authorised to provide the service.

So, if you’re considering having any work done on your face or body, no matter how minor the procedure may seem, it is important that you are properly informed and know what to look out for to ensure your health and safety. Read on for everything you need to know before heading to your consultation – the more you know, the better!

What is Queensland Health's role relating to cosmetic injectables?

Each state and territory has its own laws that govern how medicines must be handled in that state or territory.

In Queensland, Queensland Health regulates the use of medicines under the Medicines and Poisons Act and the Medicines and Poisons (Medicines) Regulation 2021.

Under these laws, cosmetic injectables are classed as Schedule 4 (S4) medicines. All S4 medicines are prescription only medicines and are subject to regulations around prescribing, dispensing, and storage.

Queensland Health works to ensure businesses and individuals that prescribe, dispense, administer or buy S4 medicines comply with regulations, such as through inspections and audits.

However, it’s also important that consumers ask questions to ensure they are aware of the products used and any risks.

As S4 medicines, these are prescription only medicines and can only be prescribed by select, authorised practitioners (such as X), and administered by an authorised registered health practitioner such as a registered nurse or doctor.

Here’s what we mean by 'prescribe' and 'administer':

• Just like other prescriptions you may get from your doctor, to prescribe means to direct a person – orally or in writing – to administer or dispense a medicine.
• To administer a medicine, including a cosmetic injectable medicine, means to introduce a dose of a medicine into the body of a person (e.g. inject).

What are cosmetic injectables?

Any substances injected in the face or body for cosmetic/aesthetic purposes are considered a cosmetic injectable with new substances frequently coming on to the market.

The 2 main cosmetic injectables used currently are:

• botulinum toxin type A (sold under brand names such as Botox^® and Dysport^®)
• dermal fillers (such as collagen, hyaluronic acid and polylactic acid).

Cosmetic injectables are classified as Schedule 4 (S4) ‘prescription only’ medicines and are regulated in Queensland under under the MPA and the MPMR.

How do I know the products being used are safe?

Only some botulinum toxin and filler products are approved by the Therapeutic Goods Administration (TGA) for use in Australia – here are a few of them:

Botulinum toxin type A

• Botox^®
• Dysport^®
• Xeomin^®

Fillers

• Juvederm^®
• Restylane^®
• Belotero^®
• Radiesse^®
• Sculptra^®

Always ask your provider what brand of botulinum toxin or filler they use and make sure they are TGA approved. Where a brand of botulinum toxin or filler is used that is not TGA approved, the quality, safety and efficacy of the medicine cannot be confirmed.

How do cosmetic injectables work?

Botulinum toxin type A

Botulinum toxin works by temporarily blocking nerve signals to your muscles, preventing them from contracting and minimising facial movements. The result? Fine lines and wrinkles soften, and new ones are less likely to form since facial movement is kept to a minimum (the muscle can’t contract, for example frown).

The effects aren’t instant – you’ll start noticing a difference around day 3 or 4, with full results settling in soon after. While botulinum toxin isn’t forever, it does last around 3 to 6 months before the muscle regains movement.

Fillers

Dermal fillers (fillers) work by injecting a gel-like substance (commonly collagen or hyaluronic acid) beneath the skin to add volume, plump up skin, smooth lines and wrinkles, and restore volume to your face.

Results from fillers will usually occur straight away and can last months (some will work for up to 2 years).

Picture courtesy of freepik.

Can anyone get cosmetic injectables?

No, cosmetic injectables are not suitable for everyone.

Before undergoing any procedure of this kind, your chosen service provider must complete a consultation with you, even if you’ve had them before.

This is so they can check your full medical history, explain risks related specifically to you, and to gain your informed consent before going ahead. It is important that you are honest and ensure a full medical history is provided, to make sure that the authorised clinician can consider the best options that are safe for you, and prescribe the appropriate injectable.

Avoid cosmetic injectables if you’re pregnant, breast feeding, immunocompromised, infected where the injection will take place, or allergic to the contents.

Can cosmetic injectables be removed after they’ve been administered?

Botulinum toxin is a neurotoxin (by definition, a substance poisonous or destructive to nerve tissue) and cannot be dissolved. Its effects will wear off naturally over time, but nothing can be done to speed up that process. However, the use of these enzymes to disperse fillers may not be suitable for everyone due to the risks associated with their use.

Some fillers, on the other hand, can be removed. Semi-dissolvable and non-dissolvable fillers (which cannot be removed without surgery) can be used in cosmetic injectables. For fillers that can be dissolved, an enzyme can be injected into the same spot to break down the hyaluronic acid molecules that make up the filler. Once broken down, the body naturally absorbs the filler remnants. However, the use of these enzymes to disperse fillers may not be suitable for everyone due to the risks associated with their use.

The effects of fillers, like botulinum toxin, will fade over time.

To find out more about types the different types of fillers, visit this injectable fillers Q&A website from the Australian Society of Plastic Surgeons.

Can cosmetic injectables move around my face?

Though uncommon, botulinum toxin and fillers can move away from their original injection site. It’s a phenomenon called ‘Botox migration’ or ‘filler migration’. These migrations can cause unintended facial contours, asymmetry, or lumps on your face.

What are the risks of cosmetic injectables?

Botulinum toxin

As with every type of procedure done, botulinum toxin carries potential risks and side effects that should be discussed and considered before you proceed. Risks and side effects can also be impacted by factors such as the dosage of botulinum toxin, injection site and technique, and your medical history.

Some of the common side effects include:

• pain, swelling, or bruising at injection site
• headache or flu-like symptoms
• droopy eyelids or crooked brows
• a crooked smile or drooling
• watery or dry eyes
• infection at the injection site.

In rare cases, botulinum toxin can spread beyond the injection site and may cause some of the below symptoms. If you experience any of these symptoms, seek medical attention immediately:

• muscle weakness
• vision problems
• trouble talking or swallowing
• breathing problems
• allergic reaction
• loss of bladder control.

Fillers

Similarly, fillers also have their own risks and side effects that you need to be aware of.

Common risks include:

• bruising
• redness
• swelling
• pain
• tenderness
• itchiness
• a rash.

Less common but more serious risks include:

• bacterial infection or inflammation.
• raised bumps
• open wounds
• allergic reaction
• skin necrosis (tissue death) – this is potentially life threatening. Skin necrosis occurs when fillers are injected into a blood vessel. If this happens, there is also a risk of stroke or blindness.

Your cosmetic injectable may be prescribed and administered by the following health practitioners (explained below).

Picture courtesy of cottonbro studio, Pexels.

Who can prescribe cosmetic injectables?

Botulinum toxin and fillers are both prescription-only medicines in Australia. You must have a real-time appointment – which can be in person or via telehealth – with a registered health practitioner before anything can be injected.

Only certain registered health practitioners can prescribe cosmetic injectables, including a:

• doctor (medical practitioner)
• nurse practitioner (NP)
• a designated nurse prescriber (more below)
• dentist (explained below).

It’s worth noting that a registered nurse (RN) is not authorised to prescribe cosmetic injectables, although they may administer (inject) them.

From September 2025, some RNs that have completed additional training and a minimum number of hours of recent clinical experience may be eligible to become a designated RN prescriber. Designated RN prescribers can prescribe medicines in partnership with an authorised health practitioner (e.g. doctor or NP) subject to some requirements. To know if an RN is a designated RN prescriber, you can check their registration for this specific endorsement on Ahpra’s register of practitioners. For more information, see the Nursing and Midwifery Board’s website.

Dentists can also prescribe cosmetic injectables, for example, if you need botulinum toxin or filler to help with things like teeth grinding or headaches due to muscle tension. The Dental Board of Australia outlines the use of botulinum toxin and dermal fillers by dentists.

It’s worth noting here that an RN cannot prescribe cosmetic injectables – it is illegal for them to do this.

What are the new guidelines announced by Ahpra?

In September 2025, new Ahpra guidelines came into effect to better protect patients undergoing cosmetic injectable procedures.

These new guidelines include:

• further training and education for practitioners
• a set period of practice for nurses wanting to expand their scope of practice to include non-surgical cosmetic procedures
• new requirements for advertisements, including a complete ban on advertising to under 18s
• a mandatory 7-day cooling off period for under 18s in between their first consultation and any procedures.

Visit Ahpra’s website for more information.

Who can administer cosmetic injectables?

Cosmetic injections can only be administered by a:

• doctor
• nurse practitioner (NP)
• registered nurse (RN)
• dentist (when it relates to dental or oral health).

While an RN cannot prescribe cosmetic injectables, they can administer them if they’ve had the right training and if a doctor or NP has prescribed the medicine. As mentioned above, dentists can also administer cosmetic injectables but are limited to doing so in the context of oral and dental health.

This is why it’s so important that you know exactly who will be both prescribing and administering your cosmetic injectable.

Does a doctor need to be on site when I get cosmetic injectables?

There is no requirement for a doctor or NP to be on site when the medicine is being administered, but the medicine must have been prescribed specifically for you.

To stay safe and ensure you have the best possible treatment, check with your clinic if a doctor or NP will be on site, or at a minimum, available for telehealth consultation during your procedure. This is the best way to minimise risk and harm to yourself. You should also obtain any necessary information from the clinic about who you can contact if you experience an adverse event following your cosmetic injectable procedure.

I’ve been prescribed a cosmetic injectable, what happens now?

In many cases, your cosmetic injectable prescription and injection are given at the same time.

Some clinics may have the medicine sent from a pharmacy and you may have a delay in your treatment. Once received, your authorised registered health practitioner will contact you to administer the injectables as prescribed by your doctor or NP.

You will not be able to get your prescription dispensed at a pharmacy to take it home. As per the script instructions, cosmetic injectables should never be taken home and self-administered as this can lead to serious health consequences. These medicines should only be administered by an authorised registered health practitioner in the clinic where you had your consultation with a doctor or NP.

Giving your prescription medication to someone else is illegal and dangerous.

Speak to your prescriber about any questions you have regarding your prescription.

What do I do if something goes wrong with my procedure?

If something does go wrong with your cosmetic injectables procedure, take immediate action. In an emergency (severe pain, difficulty breathing), always call Triple Zero (000) immediately or go to your nearest emergency department if you can.

Contact the practitioner who performed your procedure as soon as possible if you experience any swelling, discolouration, or other changes to the injection site. You may need antibiotics if it’s related to an infection.