I am still stunned to get this question after all of these years and the tremendous safety record that Botox Cosmetic has achieved. A month does not go by where someone asks me this question of, “isn’t Botox dangerous?” Here are a few things to keep in mind:
Botox is probably the safest thing that I do. It has almost no downtime, very easy for the patient, and even most serious complication (which is extremely rare) is completely treatable. There has never been reported a serious adverse reaction from Botox Cosmetic used appropriately. The short answer is NO, Botox Cosmetic is not remotely dangerous.
Botox Cosmetic has now been used for over 15 years since its FDA approval, and years before that off label. It is used to relax muscles in the upper face to minimize wrinkles and lines. There are over 5 million injections done a year. Considering this, there has never been a verified serious adverse event, reaction, or death to Botox Cosmetic when used as FDA approved. It has an incredible record of safety. The vast majority of my patients receive their medspa treatment with no downtime, no adverse events and excellent results. It is the safest and has one of the highest satisfaction rates of all of the dermal fillers and injectibles procedures performed by my practice.
Likewise, there are risks involved. Patients can have bruising requiring camouflage, which is something we strive to minimize. We use ice, pressure and other techniques to prevent brusing. In addition, the most serious adverse event is relaxation of the upper eyelid . This can make a patient appear to have a more closed eye. Fortunately, it occurs in less than 1 in 50 cases and is completely treatable with an eye medication that our office can call in for you. The last adverse event that may occur is brow ptosis. Also fairly rare, it can be prevented by conservative correction of forehead lines with careful placement. Other adverse events include potential headache (although most patients experience less frequent and less intense headaches), temporary swelling and asymmetry. Other minor adverse events can occur, but are exceedingly rare.
Botox cosmetic is used in an FDA approved fashion for glabellar lines and crows feet. It also has been used “off label” in a variety of other locations with potentially more serious adverse reactions. This includes treatments around the mouth (which can lead to problems with eating, drinking and speaking) and in the neck (which can lead to problems with swallowing and even breathing). These and other “off label” uses should be approached with more caution.
On the package labeling you will read of some of these other potential risks. Keep in mind, these relate to uses in other situations than Botox Cosmetic is used- such as large doses for muscles spasticity in children with Cerebral Palsy. These situations are far different from using this product in small doses healthy and appropriate adults with no history of a neuromuscular condition.
While all treatments carry some risks, Botox cosmetic has an extremely high safety profile and should be considered very safe when administered by trained professionals under a physicians guidance.