I. Vagal Reaction When mesotherapy is performed, the candidate must be in a lying position. In cases where mild syncope is produced, the Trendelenburg position (which is more recognized by some physicians) can be adopted and atropine (Atropina, containing belladonna) can be used. We believe that combining the two is the best course of action. Second, epigastric pain PeridilHeparine use has the potential to cause epigastric pain in combination with symptoms of generalized redness. The only thing that can mildly relieve this symptom is to take a few sips of cool water and after a few minutes the pain passes. It is very important to know the possibility of epigastric pain and to prepare the patient by telling him/her about this possible symptom before using this medication. Not only this drug, but any other drugs that can cause significant vasodilatation of the use of drugs, candidates have experienced epigastric pain symptoms. Thirdly, mechanical injuries are possible in some parts of the body where the nerves are very superficially distributed (e.g. in the epicondylar region, the medial epicondylar region of the humerus, both ankles or the fibular region, etc.), the use of injection needles for mesotherapy may cause mechanical injuries. In other areas, such as the carotid or temporal arteries, arterial damage may occur. In order to avoid these situations, it is necessary to separate the skin layer from the bony area, hold the needle with the index finger and thumb, and stick the needle carefully. It is quite normal for the injection needle to leave some small incisions when the treatment is very fast. They are very clean linear cuts that scab over leaving light colored marks similar to those left by a cat’s claw scratch. Of course, the best treatment is to prevent the incisions from appearing. Fourth, rebound effects When the goal of using mesotherapy is pain relief, there is a possibility of rebound effects. Sometimes it is a temporary aggravation of the symptoms that makes the candidate to visit the clinic, and after a few days, the symptoms continue, but with a significant improvement. Between 10% and 30% of the pain-relieving treatments performed with mesotherapy result in a rebound effect. We advocate informing the patient of the possibility of rebound. In order to avoid a rebound, we can achieve a balance by stimulating the three connecting points (Darwin’s point, Cero’s point, and the mesencephalic point, which Ballesteros has mentioned) with the same mesotherapy injection needle. Dr. Pistor advocates the implementation of pure mesotherapy to stifle the rebound of pain. V. Hematoma A hematoma occurs as a result of improper use of an agent. Its appearance indicates that the needle was inserted too deeply and/or altered the normal parameters of blood clotting. In the treatment of orange peel, hematomas appear quite often. As a general rule, in order to avoid the appearance of hematomas, mesotherapy injections should be performed to a depth of less than 4 mm. in case of accidental appearance of hematomas, they should be squeezed and some gel or emollient oil should be applied on them, which will help to prevent the aggravation of the symptoms (e.g. Feparil gel). Tip: Why can’t I have a hydrafacial treatment during my period? Because a woman’s body resistance is lowered during menstruation, it is easy to cause bleeding, it is harder for the bruises to fade away after injection, and the pain is more obvious during menstruation, which is a big burden on the body to choose to inject at this time, so doctors usually avoid hydrafacial treatments during menstruation. At the same time, due to the pain and drug stimulation after hydrotherapy, it may cause irregular menstruation or abnormal bleeding, affecting the endocrine regulation, so it is best not to carry out any surgery as well as medical treatment during menstruation.