The use of neuromodulators for cosmetic purposes has a remarkable safety record; nevertheless, unwanted effects can and do sometimes occur when neurotoxins are used for facial rejuvenation, such as neutralizing antibodies and eyelid ptosis. The primary objective of the following roundtable discussion was to review the most commonly reported complications from neurotoxins and summarize considerations for reducing the risk of complications. A roundtable discussion was held by 5 notable experts in their field during a special addition of the Thriving in Diversity webinar series on Thursday, February 15, 2024. Three presenters were provided with an opportunity to share their knowledge. Common complications associated with the use of neuromodulators include lack of response due to neutralizing antibody formation and eyelid ptosis. Common complications, such as neutralizing antibodies, can often be prevented by avoiding known risk factors. The use of topical alpha adrenergic agonists can often improve the appearance of eyelid ptosis. The cosmetic use of neuromodulators remains extremely safe, and serious adverse events rarely occur. J Drugs Dermatol. 2025;24(1):7-11. doi:10.36849/JDD.8355.