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Perlane and Botox Safe when Nursing?

I received Botox and Perlane treatment yesterday and discovered it can cause harm to a nursing baby. I have a 10 week old son and I am incredibly concerned. The administering physician did not tell me about the potential harm. Please help!

Doctor Answers 12

Botox, Perlane in Nursing Mother

HI Blake,

We do not inject pregnant or nursing mothers with Botox and Perlane mainly because of the litiginous society that we live in. Studies have not been performed to test whether there is significant amounts of Botox in mother's milk, but most physicians believe that if there is any, it is miniscule, and should not affect your infant.

You are not the first, nor the last nursing mother to get Botox while nursing, just don't have it done again until your little tiger is off the breast.

Good luck, be well, and Happy Mother's Day.

Dr. P

Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

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Perlane after childbirth

Perlane is a hyaluronic acid filler and can be scheduled for injection during your breast feeding period.  Specific recommendations for your breast feeding will then be given for you to safely resume your lactation and breastfeeding. The risks of Botox should be discussed with your injector. 

Raffy Karamanoukain MD FACS

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 57 reviews

Breast feeding and fillers and Botox

I would not recommend Botox or fillers at the time of breast feeding. While I doubt they will cause a problem, no one knows for sure.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Do not use Botox or Perlane while breastfeeding

There are no studies that show the dangers of breastfeeding while using products such as Botox and Perlane. But I would not inject Botox or any fillers while pregnant or breastfeeding because we don't know the safety of these products to the baby.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 13 reviews

Hold Off For Now

There are no studies to indicate the teratogenic effects or if either product can be found in breast milk.  There are no contraindications in pregnant or breast feeding mothers in the FDA approvals.  However, it's always better to safe than sorry.  So I would not recommend breast feeding.

Not advised

Hi, although there are no studies on the use of Botox and Perlane while breastfeeding, it is generally not recommended. Although it is unlikely that these could enter the bloodstream and your baby's milk, I would suggest that you speak to your physician in the event that he/she was not aware that you are breastfeeding. It may be wise to hold on breastfeeding for now given the situation. Good luck.

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.0 out of 5 stars 5 reviews

Botox and Fillers while nursing

While it is a general rule that Botox and fillers should not be administered while nursing, it is unlikely that there will be any effect on your baby. The amount of Botox is small and the amount that would get into the general circulation is miniscule. Hyaluronic acid used in the Perlane is bascially a complex sugar which occurs naturally in our joints and our areas and should not pose any problems. But as a general rule, avoid these treatments during pregnancy and nursing.

Robert A. Weiss, MD
Baltimore Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

OK there are no studies that show this is safe.

Dear Blake

Our forms indicate that you should not receive any services while pregnant or nursing. There will never be a study to determine if this practice is safe. You need to be aware that many products find their way into the breast milk.

Having said that, take a deep breath and forget about it. The Perlane is a very thick material that occurs naturally in the body. It is unlikely to get into the breast milk but even if it did, it is very unlikely to cause any harm. The BOTOX is also such a tiny amount that very little of it circulates. Most of it is immediately absorbed by the tissues being treated. Theoretically a minute amount could possibly make it into the blood stream and ultimately the breast milk but it is likely to be undetectable. It is very, very unlikely to have any effect on your baby. Yes infants have died from medical BOTOX treatments however, these are very sick infants receiving very large doses of BOTOX-- So not your situation.

Yes, bad you did not tell your doctor that you were breast feeding. You should know better. Yes bad that your doctor did not ask you if your were pregnant or breast feeding. Don't do it again. Now forget about it. Breast feed your baby, it is good for both of you. And don't share the story with your new mothers group because they will think that you are some type of child abuser.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 19 reviews

Did you inform the doctor?

Was the treating physician informed that you were breast feeding? It is always important to tell your physician about your health and activities before undergoing any medical procedure, even if the procedure is minor and you have undergone the procedure before.

I am not aware of any way the Perlane could get into your blood stream, and the amount of toxin in the Botox dose (I am guessing you are young and do not need high doses) is likely inconsequential, but there are no studies to prove this. Most pregnant and nursing moms take a break from elective procedures just to be on the safe side.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 10 reviews

Perlane and Botox while nursing.

Perlane is extremely unlikely to pose any risks while breast feeding. Botox poses a theoretical risk. It is not known whether Botox passes through breast milk. Botox is only minimally absorbed in the bloodstream and I see no reason why it would concentrate in the bloodstream. You may wish to discuss this matter with your ob-gyn though they are unlikely to give you a definitive answer to your question. I believe the risk is low, but you must weigh the risk and benefits of continued breast feeding.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.