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How is Botox Safe if There Are Warnings About Complications?

I was checking out Botox Prescribing information and the first thing I read is a warning that Botox Cosmetics may spread from the area of injection and may cause, among others, difficulties breathing and swallowing that can be life threatening.

How can Botox be considered a safe procedure with this kind of warning?! Now I'm definitely scared.

Asked 29 months ago by Maya79 in New York

Tags:

complication safety side effects

Botox Safety

Hi Maya, Botox Cosmetic has the same warnings that accompany Botox for the non-cosmetic uses for Cerebral Palsy and other types of muscle spasms even though the amounts of Botox are dramatically different when used for cosmetic purposes. Botox Cosmetic has a better safety record than aspirin. So, while we understand your concern after reading the warnings, if you read the warnings on other common medications, you would find that many have similar imposing warnings. If the risks seem too... more

Doctor's Website

Harold J. Kaplan, MD

Los Angeles Facial Plastic Surgeon

Botox is actually safer than Aspirin

Botox is not recommended for any patients that have an allergy to Botox, a skin infection at the site of the injection, a muscle or nerve disease, breathing issues, swallowing issues, bleeding issues, an upcoming surgery, previous facial surgery, weak forehead muscles, drooping eyelids, or are pregnant or breast-feeding. If you do not fall into any of those categories, and have made sure you are getting authentic Botox manufactured by Allergan and administered by a trained and... more

Steven Svehlak, MD

Los Angeles Plastic Surgeon

ASAPS ASPS

Botox side effects

It is important to read and understand all the possible side effects from Botox injections. However, as with any medicine, the serious side effects, are uncommon. The typical side effects after injection that occur up to 5 % of the time include mild injection site bruising, ptosis, and occasional headaches. Botox has been used millions of times for many reasons and not for just cosmetic purposes and the reported incidence of serious side effects is extremely low .

Doctor's Website

Steven Hacker, MD

West Palm Beach Dermatologic Surgeon

Botox is a medical treatment

The side effects you mentioned are expressly described by the company for having been noted after Botox was used for neurologic uses such as muscle spasm. They continue to state that these side effects have not been noted with cosmetic use as indicated by the company. Neurologic use of Botox involves a much higher number of units than what is used for cosmetic purposes. It is important for all to be mindful that Botox is a medical treatment and with all treatments, there are risks.... more

Ronald Shelton, MD

Manhattan Dermatologist

How safe is Botox!

Very safe when used appropriately by a board certified expert. Of course there is nothing that cannot be done incorrectly so I would suggest going to the best person you can find. I find that my Botox patients are among the most satisfied with their procedure. Hope this helps.

Doctor's Website

Beverly Johnson, MD

Washington Dermatologic Surgeon

Is Botox Safe?

Yes! If used properly, like anything else. The only major complications have arisen using Botox off-label for unapproved uses, especially in high doses in children for neurologic diseases. The warnings are necessary for your own decision making and to discuss with your doctor. There are side effects, but following proper cosmetic use with proper technique and dosing, these should be temporary and reversible.

Michael Coverman, MD

Austin Dermatologist

Botox and Safety

My question is then do you read the insert on aspirin, tylenol and motrin. If you have then you would not be taking those either. There are always risks with everything that we do in our daily life, like crossing the street and driving a car. It all depends if the risks are realistic and common or not. So......having said that, botox is relatively safe and given the amount that has been used across the country and world, we know it safety parameters. You may still not desire to have this don more

Farbod Esmailian, MD

Orange County Plastic Surgeon

ASPS

Risks of botulinum toxin

IF you are scared then don't do it. It is not for you and you may not be a risk taker. But if you read the side effects of aspirin or ibuprofen, my guess is you would be scared and should not take them either. It is my opinion that botulinum toxin when administered properly is safer than aspirin.

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

Very Safe

As I understand it, there has not been a death from Botox when it was administered for cosmetic use.The warning regarding migration of Botox would have more to do with injection into sensitive areas. Certainly, if injections of over 400 units are given, say for cerebral palsy, one must be especially cautious, but for the amounts given for cosmetic use I would not be concerned. All the reports of respiratory paralysis when it was given cosmetically, were due to laboratory or bogus... more

Arnold R. Oppenheim, MD

Virginia Beach Dermatologist

Botox is totally safe if properly used.

Hi! Botox itself is really, really safe. The warnings are necessary because of possible misuse. Too much Botox can be used, and it can be injected into dangerous, inappropriate places. So it's all about who gives you the Botox. Go to an experienced plastic surgeon or dermatologist.

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Botox and safety label

The safety label lists many things including the ones you mentioned. The risks of the ones you mentioned are extremely rare but have been reported, so the FDA made it mandatory to have them listed.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Botox safety and warnings of complications

Dear Maya79, A few questions:- do you really need to be told NOT to use a hair dryer in a water filled tub or in the shower?- Have you read the side of ANY ladder in your neighborhood Lowe's or Home Depot?- How about the "instructions" on the use of ANY household appliance and every single medication? The initial reaction is a smug feeling of superiority and a thought along the lines "...there must be a lot of morons out there that this is written for". Well, 304,059,724... more

Peter A. Aldea, MD

Memphis Plastic Surgeon

ASPS

Botox, How Can it Be Safe With All the Warnings on the Product Information Sheet?

Hi Maya, As long as there are attorneys, as long as there are major corporations such as Allergan, as long as there are doctors who misuse products, and as long as there are patients who have complicated lives, there will be warnings on medical products. As part of an informed consent prior to any surgical procedure we have for years included the possibility of horrible complications up to and including death. Fortunately, those complications are extremely rare. The same holds for Botox... more

Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon

Botox warnings

Used in the correct manner and doseages, Botox carries minimal risks for the abovementioned problems. Make sure you go to a physician who routinely uses Botox in the correct manner. Extremely large doses used for mostly non-cosmetic reasons can be associated with the risks mentioned. Cosmetic usage of Botox rarely results any problems except for some redness at the injection sites that last for 1-2 hours.

Jeffrey E. Schreiber, MD

Baltimore Plastic Surgeon

ASPS

Botox Has Excellent Safety Profile

Botox is like any other medication. You read the insert and you will find out all the possible side effects which can be scary. The reality is that Botox is a very safe medicine. The side effects are unlikely to be seen at the recommended doses. If someone is really concerned about safety then they might want to start with small dose injection of botox. This helps build confidence in its safety and then slowly you can increase the dosage to the usual recommended amounts. Regards more

Tanveer Janjua, MD

Bedminster Facial Plastic Surgeon

Explaining the Botox warnings

Here's the short answer: In the "Medication Guide" that we are to give to patients, after it mentions the alarming possibilities that you mention, it then goes on to say "There has not been a confirmed case of spread of toxin effect away from the injection site when Botox has been used at the recommended dose". Here's the longer explanation: Because Botox is the same molecule that causes botulism poisoning, in extremely high doses it can cause problems by spreading beyond... more

Richard Baxter, MD

Seattle Plastic Surgeon

ASAPS ASPS

There are warnings on any drug.

Please look at the warnings on any drug available today, including aspirin. There will be warnings of allergic reactions, death, etc. Botox is no different. It is a safe drug based on how many times it has been used over the past 15 years. However, just like getting in a car, there is no guarantee that it is completely free of risk.

Francisco Canales, MD

Santa Rosa Plastic Surgeon

ASAPS ASPS

Botox safety

Botox (direct from the manufacturer, Allergan) has a long track record of safety, when used appropriately for cosmetic purposes. There are, of course potential complications for any cosmetic treatment you could undergo, and Botox is among the safest. Good luck.

Bryan K. Chen, MD

San Diego Dermatologist

BOTOX is extremely safe

Dear Maya BOTOX is one of the safest drugs available with an amazing twenty year track record. It has literally changed the lives of millions of people for the better. Having said that, drug safety is often a question of dose. Two aspirin makes your headache better but twenty aspirin gives you a bleeding stomach ulcer. This is also the case for BOTOX. The doses of BOTOX and Dysport used for cometic purposes are very safe. There are no life threatening issues with these treatments.... more

Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

Botox is Safe

Botox is, without a doubt a miracle drug. It helps people with muscle spasms, double vision, headaches, spastisity that occurs following paralysis or strokes, pain following certain neurological conditions and excess perspiration. It is also amazing as a cosmetic treatment and, in fact is the most commonly performed cosmetic procedure in virtually every country in the world. As you might guess, treatments for some of these serious medical conditions are very different than for facial... more

Marc Cohen, MD

Philadelphia Oculoplastic Surgeon

Botox

Don't be scared Maya. Botox is an extraordinarily safe drug which has been used in millions of people since it's inception in the 80s. The reason that you see that a warning is because in a few cases (again, out of millions) where botox was used for therapeutic treatments (not cosmetic treatments) for people with muscle spasm and other ailments, they had spread of the botox such that there were breathing problems. This is true because of the amount of botox that is used to treat those... more

Elan B. Singer, MD

Manhattan Plastic Surgeon

ASPS

Botox is Safe for Cosmetic Uses

Botox has been used to treat a variety of medical and cosmetic issues for a few decades. Its initial use, in fact, was to treat babies with cross eye back in the 1980s. When used for cosmetic purposes, very small amounts are used and, thus, Botox is very safe. Of all the treatments that cosmetic surgeons provide, Botox is among the safest. There have, however, been some serious problems with Botox and this is the reason for the FDA warning on the prescribing information. These serious... more