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Botox Side Effects

asked 4 years ago by anon
Latest answer by Sanusi Umar, MD
Question viewed 121,643 times
Tags: risk, side effects

I read that Botox has some side effects like droopy eyelids. Is Botox safe?  Any tips for making sure my Botox (first time!) has no bad side effects?

52 answers to Botox Side Effects

+2

Experience and training is key to avoid Botox side effects

Botox has a better safety record than aspirin so it is very safe. To avoid the potential side effect of droopy eyelids make sure your practitioner is well trained and experienced in the use of Botox. He/she should have performed hundreds (preferably thousands) of injections. Ask what training your practitioner has undergone and how often he/she updates their training with Allergan sponsored seminars.
Harold J. Kaplan, MD

Los Angeles Facial Plastic Surgeon

www.celibre.com

+1

Avoiding common Botox side effects

Botox is one of the most widely-investigated products on the market. There are over 20 years of strong evidence that points to its safety when it is injected properly by an experienced doctor. Like any treatment, it does have some side effects, even when used perfectly. These can include pain, bruising, and allergies in extremely rare cases. It is critical to inject the right dosage or strength of Botox in the right muscles of the face to minimize some common side... more
Daniel Yamini, MD

Los Angeles Plastic Surgeon

www.sunsetcosmeticsurgery.com

+6

Side effects result if Botox is not done properly

Botox injections can cause side effects if not done properly. A good plastic surgeon will start with a lower dose and adjust the dosage to get the desired results. The skill part of injecting Botox is understanding the anatomy of the facials muscle, especially around the eye. It is also critical to inject the right amount of Botox in the right places to avoid side effects. If too much Botox was injected above your eyebrows or if some Botox migrates into the levator palpebrae muscle that... more
Daniel Reichner, MD

Newport Beach Plastic Surgeon
+5

Botox is safe as ever

The recent stir about the safety of Botox has nothing to do with the cosmetic use of the anti-wrinkle miracle drug. It is still as safe as ever to have a few of your wrinkles erased by Botox. We have used Botox over the past 30 years without any of these recent adverse effect reports. The FDA is reviewing botulinium-based drugs used to treat cerebral palsy and other ills. There have been reported cases of breathing and swallowing problems in pediatric cerebral palsy patients, and even a... more
Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon
+2

Avoid droopy eyelids

While there is no full proof technique to avoid botox side effects, going to an experienced doctor who performs the procedure on a regular basis is a good start. In addition , if you don't ask the doctor to 'over treat', or inject wrinkles that are too close to the eyebrow, this should lower the risk of an eyebrow droop. Good Luck!
Joshua L. Fox, MD

Long Island Dermatologic Surgeon
+2

Botox is safe if the physician is experienced and artistic.

Congratulations on deciding to try Botox! If properly done by an experienced, careful, creative, and artistic board-certified dermatologist or plastic surgeon, there should be no trouble. Side effects can occur from use of too much Botox, improperly placed Botox, or poking a blood vessel, which can lead to a small bit of bruising. For a first time treatment, it is perfectly fine to ask your doctor to be conservative so you can get used to the effects of a small amount until you feel... more
Jessica J. Krant, MD, MPH

Manhattan Dermatologic Surgeon

www.ArtofDermatology.com

+2

Botox Side Effects

The most import decision regarding Botox is to go to a physician or injector with a long vast experience.  The quality of your result and possible side effects are a direct result of the technique used:  the dilution of saline to botox, direction of injection, and the anatomical areas injected.  Drooping of the eyelid (ptosis of the eyelid) occurs infrequently.  The cosmetic literature reports an incidence of around 1-2%.  In our experience this is reduced even... more
Neil J. Zemmel, MD

Richmond Plastic Surgeon
+2

Botox Side Effects and Complications

I agree with posters that the experience of the injector is critical to achieving good results in a consistent fashion, avoiding potential pitfalls.  Several things I encourage my patients to avoid after Botox: 1) avoid rubbing the treated area for 24 hours, 2) avoid facials, facial massage, Microdermabrasion for 24 hours after the procedure, 3) avoid aspirin, fish oil, excess vitamin e for 1 week before and 24 hours after the procedure.  From a technical perspective, use of Botox... more
Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon
+2

Experience Counts

Sorry this is such a short answer.... Experience with Dysport or Botox matters. Go to someone that has done hundreds. In experienced hands it is very safe and reliable, yielding excellent results.
Vineet Mehan, MD

Washington DC Plastic Surgeon
+2

Botox results often depend who is on the other side of the needle

Sure, bruising, drooping and any side effect can happen to anyone. If a doctor has not had dropping with Botox then he/she has not done enough Botox. The key is to find someone with a great understanding of facial anatomy and extensive experiece with Botox. As a facial plastic surgeon and a platinum provider of Botox I still get some of these things. The good thing is that they are very uncommon and usually very mild. So experience, background and training do matter.
Robert F. Gray, MD

Bay Area Facial Plastic Surgeon
+2

Botox has excellent safety profile. Experienced injectors mean less bad outcomes

Botox has an excellent safety record in terms of medical complications. The effect however, is designed to work in some areas and not others. Therefore, it's the experience and training of the injector that really leads to optimal results in terms of patient satisfaction. The number one concern seems to be eyelid drooping. In our practice, we boast ASOPRS-certification. This is the society of oculofacial plastic surgeons, that is surgeons who are double-trained in eye surgery and facial... more
David M. Mills, MD

Pensacola Oculoplastic Surgeon
+2

There are a lot of ways to make Botox safe and avoid complications

Botox can be done in a safe way to avoid problems. First off, diluting the botox with less solution can go a long way. I typically use only 2cc of botox where some other physicians use up to 4 cc of saline. When you use more saline, you end up needing more volume for the same number of units. What this means is that the more volume you use the more the botox will be spread out. When the botox is spread out, it can affect other muscles around the area and cause unwanted effects. In your... more
Philip Young, MD

Bellevue Facial Plastic Surgeon
+2

Avoid botox side effects by fake or imported product

At this time, the manufacturer of Botox (Allergan) is the only provider of Botox to doctors’ offices in the US (outside of a few other clinical trials). If you were to find someone that has bootlegged a Botox-like product, a copycat from another country, or bought it from a different manufacturer, that would be huge red flag and very dangerous as they might not be using the purified derivative of the Botulism toxin Consult with a reputable plastic surgeon or dermatologist before... more
Jennifer Walden, MD

Austin Plastic Surgeon
+1

Botox Side Effects

Botox is considered to be generally safe and has received FDA approval as a result. Like any other form of medical treatment, there are associated side effects Botox, such as droopy eyelids. In order to help ensure that your first experience with Botox is a successful one, it is essential that you choose an experienced board certified specialist who can properly evaluate you for complications and side effects. For example, Botox is contraindicated in individuals with neurological conditions.... more
Sanusi Umar, MD

Redondo Beach Dermatologic Surgeon
+1

Botox is safe

Botox is very safe with minimal side effects. Botox only lasts 3 months, so if you did get a droopy eyelid it would subside when the Botox wears off. An experienced Botox injector would be able to adjust the dosage and technique to prevent a droopy eyelid from occuring again. Make sure you have a board certified physician perform or supervise your Botox injections.
David Finkle, MD

Omaha Plastic Surgeon
+1

You can reduce your risk of a bad Botox injection

The most important thing to do to reduce your risk of a bad Botox injection is to select and experienced injector. Bruising is a risk with any injection, so avoid taking anything that can thin your blood for at least 10 days before your treatment such as aspirin. To reduce your risk of a droopy eyelid with a brow injection, do not rub the area that was injected and avoid strenuous activity for several hours after your treatment. The good news is, if you don't like your... more
James McMahan, MD

Columbus Plastic Surgeon
+1

Botox side effects

The most common side effects of Botox include mild discomfort at the site(s) of injection, temporary redness at the injection site and possible bruising. Rarely, patients may experience a headache. The incidence of an eyelid droop is very rare occurring in about 1% of patients. It is temporary and usually resolves in a few weeks.
Lori Stetler, MD

Dallas Dermatologic Surgeon
+1

Botox safety 101

The likelihood of eyelid ptosis, or drooping of the eye lids is not as common particularly if you have the proper administrator, meaning a board certified dermatologist or facial plastic surgeon. Botox has been FDA approved in the United States for years, and has had a vast amount of positive feedback and safety trials. In addition I would avoid massaging the injection sites for about 24 hours after the procedure.
Yael Halaas, MD

Manhattan Facial Plastic Surgeon
+1

Droopy eyelids from Botox

Droopy eyelids can rarely happen  following Botox Injections. Nobody can actually guarantee that you won't have this complication, because there can be occasional  variations in a person's muscle distribution width. But to lower your risk, it is important that you  have your injections done by an experienced  Board Certified Dermatologic or Plastic Surgeon.
Eugene Mandrea, MD

Chicago Dermatologist
+1

Botox side-effects

Droopy eyelids is a technical problem, not really a complication. Botox was either injected into an incorrect area or it was allowed to spread there. While there is no fool-proof way to avoid technical problems, your best bet to avoid it is to ensure your doctor is well experienced with BOTOX injections. Sincerely, Martin Jugenburg, MD
Martin Jugenburg, MD

Toronto Plastic Surgeon

www.torontosurgery.ca

+1

Avoiding Botox Side Effects

Most of the "side effects" described for Botox are associated with the Botox spreading to adjacent areas that you don't want to treat. As such, the best way to decrease the risk of side effects with Botox is to seek treatment with a physician with training in anatomy, injection technique and Botox use. In my opinion you should look for a dermatologist, plastic surgeon, facial plastic surgeon or oculoplastic surgeon with extensive experience in using Botox.
Andrew Kaufman, MD

Los Angeles Dermatologic Surgeon
+1

Botox is safe- make sure you have a proper physician that is injecting

Yes Botox is safe. Eyelid drooping is a possible reaction but is uncommon. It is best to see a Facial Plastic Surgeon who frequently performs Botox injections and is most familiar with the facial muscles and aesthetic effects Botox has.
Michael Sullivan, MD

Columbus Facial Plastic Surgeon
+1

Botox - side effects

Droopy eyelids can occur if botox is administered too close to the brow.  This is very uncommon, but is just a technical problem.  I would recommend going to an experienced injector who has a good understanding of facial anatomy.  Also if you are nervous, talk to friends or other people you know that have had it.  I personally have been getting botox injections since my late 20's and really love it's results.  You should feel free to talk to your doctor... more
Catherine Huang-Begovic, MD

Beverly Hills Facial Plastic Surgeon
+1

Botox: minimal incidence of adverse side effects when administered by an experienced practitioner

Certainly I can understand feeling a bit anxious before trying something new. However, rest assured Botox is a very safe procedure when administered by an experienced practitioner. While some practices rely on ancillary staff (usually nurses, but not always) to administer Botox, I prefer to administer it myself, and my patients respond well. The likelihood of ptosis (eye drooping) is minimal. 
Peter Schmid, DO

Longmont Facial Plastic Surgeon
+1

Risks with botox can be minimized

The usual side effects such as bruising sometimes can't be prevented.  Droopy eyelids which occur in 2-3% of injections around the eyes can be reduced using good technique.  In well trained hands it is extremely safe and effective.
Randy Proffitt, MD

Mobile Plastic Surgeon
+1

Minimizing Botox side effects

Although Botox is generally very safe, unwanted side effects including droppy eyebrows or eyelids can occur. The good news is that there are not permanent-- Botox is generally out of your system in 3-4 months. The number one way to minimize your risk of side effects is to see a physician who is well-trained and well-informed. Good luck, Dr. Rupani
Reena Rupani, MD

New York Dermatologist
+1

To avoid complication, begin with limited areas and experienced injector.

Few complications come in the hands of experienced injectors when the injections are limited to the areas about the lids. However, complications are more frequent when doing the mouth, neck, etc. Therefore, we begin first time patients in limited areas and very carefully diagram areas treated and amounts used.  From the initial response we can modify what we will later do. Dr. Mayl Fort lauderdale
Nathan Mayl, MD

Fort Lauderdale Plastic Surgeon
+1

Botox complications

Eyelid ptosis is the biggest concern and probably the most severe complication of botox use. It occurs rarely and if the surgeon is experienced should happen almost never. If it does occur the problem is temporary.  There are no other significant coplications reported with the use of botox
Richard Galitz, MD

Miami Facial Plastic Surgeon
+1

Minimize Botox side effects

Botox may have side effects, especially when injected by non-experts. Eyelid droop is one potential side effect... that's why it's important to see a practitioner with extensive experience with botulinum toxins. The best tip for a great outcome is to see a dermatologist or plastic surgeon with years of experience injecting Botox, not someone in a recently-opened retail medspa. Knowing the facial anatomy and appropriate dosing for your amount of "muscle mass" around the eyelids are... more
Chad L. Prather, MD

Baton Rouge Dermatologist
+1

Botox side effects

The best way to avoid avoidable side effects is to go to an experienced injector. Droopy eyelids is often an avoidable side effect. While it can rarely happen with proper injection technique in most cases it doesn't. I have used Botox for my patients for well over 13 years with very satisfying results.
Carlos Wolf, MD

Miami Facial Plastic Surgeon
+1

The Most Important Tip for avoiding problems with Botox

Hi there- There can be no doubt of the safety of Botox. It is reliable, and patient satisfaction is overall extremely high. When patient satisfaction after Botox IS experienced, it is almost always attributable to inexperience and poor technique on the part of the injector. There are many reasons that nice people like yourself are being led to believe that anyone can inject Botox and the results will be equivalent- but common sense says otherwise. Are human beings exactly the same in any... more
Armando Soto, MD

Orlando Plastic Surgeon
+1

Side effects to Botox

First you need to go to a experienced injector. Ask the injector about their training and how long they have been injecting Botox. Botox side effects are typically minimal in nature. You can experience swelling or bruising at the injection site. Avoid aspirin, ibuphen, vitamin E, and some herbal products to reduce bruising seven days before treatment. Apply ice at the site to minimize bruising & swelling. Make sure the Botox is FDA approved by Allergan. It's in a box with a hologram on... more
Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon
+1

Botox

How to insure a good first experience? I would suggest going to a qualified person who has alot of experience injecting Botox. This usually means a board certified doctor who was trained in facial aesthetics. 
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Avoid Botox side effects

If you choose to go to an experienced and trained dermatologist or plastic surgeon for you botox injections, side effects are quite uncommon. If they were to occur, however, side effects could include bruising (usually resolves in 4-5 days), the occasional headache, and very rarely a drooping of the eyelid or eyebrow. Drooping typically occurs when too much Botox is injected in one place or when Botox is injected too close to the eyebrow or eyelid. As Botox is not permanent, all these side... more
Channing R. Barnett, MD

New York Dermatologist
+1

Botox for the first time

The main tip: use an experienced well-trained injector. Side effects happen, but they are extremely rare. Four specialties are qualified to administer facial cosmetic treatments: facial plastic surgery, dermatology, oculoplastic surgery, and plastic surgery. Choose one of these, but make sure they have years of experience including hundreds if not thousands of patient injections. Good luck and enjoy your Botox!
Stella Desyatnikova, MD

Seattle Facial Plastic Surgeon
+1

Botox side effects caused by bad technique.

Hi. Botox is extremely safe.  But some inexperienced doctors who use Botox may not be safe. The side effects I know about are due to either using too much Botox, or by putting it in the wrong place (like too close to the upper eyelid).
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

Botox side effects minimized

BOTOX side effects in the hands of an experienced and trained dermatologist or plastic surgeon is quite uncommon. The main side effects would be a slight discomfort (like a mosquito bite), tiny bruise, the occasional headache, and rarely a drooping of the eyelid or eyebrow. A "spock brow" can also occasionally occur but is very easily fixed. In trained hands, these problems are uncommon, easily fixed, or quickly resolve on their own.
Benjamin Barankin, MD

Toronto Dermatologic Surgeon
+1

Droopy eyelids following Botox

Complications following Botox treatment such as droopy eyelids is very uncommon. Botox has an excellent safety record. The most important issue when considering a Botox treatment is the experience and qualifications of the injector. Don't go just for price. There is a lot of skill involved with Botox treatments. Botox is a powerful chemical which can create muscle imbalances and abnormal facial expressions. A skilled injector knows the anatomy and can avoid or correct such problems. The... more
Todd B. Koch, MD

Buffalo Plastic Surgeon
+1

How to avoid side-effects with Botox and Dysport

Adverse events after Botox injections received a lot of attention after the FDA mandated a "boxed warning" for both products. The patient Medication Guide lists a range of horrible things such as loss of bladder control or inability to speak; though these messages are required by the FDA, no serious adverse events related to spread of the product beyond the injection site have ever happened with cosmetic doses. This despite the millions of injections that have been done. One really... more
Richard Baxter, MD

Seattle Plastic Surgeon
+1

Botox has an excellent safety record

Botox has been used for many years and has an excellent safety profile, but no procedure is entirely 100% risk free. To ensure that you have the least chance of any adverse effects, be sure that you receive your treatment from an board certified dermatologist or plastic surgeon who has experience with Botox injections. No matter who does your injections however, you may have some redness at each injection site and/or or a little bruise. Whether or not you will bruise is unpredictable. ... more
Jordana Gilman, MD

New York Dermatologic Surgeon
+1

Botox is very safe

Droppy eyelids from botox are extremely rare. What is more common is a lower or flatter brow from too much relaxation from botox in the forehead. If your forehead becomes completely relaxed then you may not be able to raise your eyebrows - this leads to a feeling of heavy brow and can make the brow flat and seem like you have droopy eyelids but the eyelids really are just weighed down by the heavy, relaxed brows that are no longer raised up by forehead muscles. The goal of botox is to... more
Elizabeth F. Rostan, MD

Charlotte Dermatologist
+1

Avoiding the bad Botox is easy

There is a LOT of BAD BOTOX out there. But it is so easy to avoid it. Easy answer - Be Smart. Just get your Botox from a REPUTABLE physician ; either Plastic surgeon, Dermatologist or a Facial Plastic surgeon. Do NOT get it in a salon, a "Botox Party" or from another MD (such as a family practitioner etc), DO (osteopath) or DC (chiropractor). Personally - I KNOW that a DOCTOR can always do a better job than the vast majority of "injectors" out there so I would recommend... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Avoid massaging after Botox or Dysport injection

Ideally, Botox injections should be performed by a board-certified dermatologist or plastic surgeon. Besides the precision and experience of your physician injector, you should refrain massage the skin areas after Botox or Dysport injection for the rest of the day to minimize migration. Inadvertent or unintentional massage of forehead area after Botox or Dysport can lead to droopy eyelids or ptosis. In the event of droopy eyelids after Botox or Dysport, be reassured that it usually... more
William Ting, MD

Bay Area Dermatologic Surgeon
+1

Botox side effects are typically minimal if they occur

Botox side effects are typically minimal if they occur. One can avoid botox side effects by not asking or having excessive amounts placed at the initial or repeat injection time. Also, most of the side effects such as droopy eyelids can be avoided by going to experienced injectors; howevever, even in experienced hands this can sometimes occur. If a droopy eyelid should occur, this problem can be temporarily corrected with naphcon eye drops when in public to help lift the droopy eyelids... more
Scott Trimas, MD

Jacksonville Facial Plastic Surgeon
+1

Botox safety

In general , Botox is safe. The key precaution that you can take before getting Botox treatment to minimize risks is to get the treatment from a qualified, board certified dermatologist or plastic surgeon. The physician should have experience with Botox and the patient should have comfort that the physician is using "Botox" from Allergan. Otherwise, there really is not much you can do to prevent the minimal risks associated with Botox therapy.
Steven Hacker, MD

West Palm Beach Dermatologic Surgeon

www.palmbeachdermasurgery.com

+1

Botox side effects

Any experienced injector who is properly trained and credentialled can minimize or eliminate side effects related to Botox. Botox should be stored properly and used within the prescribed time. Therefore, the physician that you go to must have sufficient patient flow to utilize the product in a timely manner.
Kris M. Reddy, MD, FACS

West Palm Beach Plastic Surgeon

www.drkrisreddy.com

+1

Seek the right Botox provider to avoid side effects

To reduce the chances of a bad cosmetic Botox or Dysport outcome, make sure you are treated by a physician who is appropriately trained and appropriately board certified (for example, a plastic surgeon, facial plastic surgeon, or a dermatologist). These individuals will have the largest injectable experience. I tend to think that other types of doctors whose primary focus is not cosmetic (such as internists or gynecologists) will run you the risk of a less than ideal outcome. Same with nurse... more
Randolph Capone, MD

Baltimore Facial Plastic Surgeon

www.baltimorefaces.com

+1

Easy to administer Botox, difficult to deal with possible complications

I would echo the sentiments of the other answers. There has been a recent review by the FDA of the safety of Botox due to several adverse reactions. From the information provided by the FDA, the adverse events seem to have occurred in children less than 12 years of age and in adults where large quantities of Botox have been administers (100-700 Units). In the adult group, there were hospitalizations but no deaths or even need for ventilatory support. In my practice, I administer 20 Units of... more
D.J. Verret, MD

Dallas Facial Plastic Surgeon
+1

Botox Complications, avoiding problems

Botox does not have many side effects, but the more common side effects are bruising and inflammation, which are always a risk for any type of injection. These side effects can’t be totally prevented, but abstaining from taking any ibuprophen, aspirin, vitamin E, St.Johns Wart and alcohol for one week prior to injection and being treated by an experienced medical professional can lower the risk. Choose your injector carefully. Look for someone experienced. Most plastic surgery... more
Michael Law, MD

Raleigh-Durham Plastic Surgeon

michaellawmd.com

+1

Botox and safety

The cosmetic use of botox is safe. There have never been any deaths or permanent effects. A droopy eyelid occurs when botox infiltrates into the muscle that lifts the eyelid. It can happen to inexperienced and experienced injectors alike. It is probably more likely in an inexperienced injector's hands. There is nothing to really prevent this  complication except the obvious. I wouldn't start massaging the botox near the eyelid after the procedure. I would probably not go... more
Chris Thiagarajah, MD

Washington DC Oculoplastic Surgeon
+1

Botox has an excellent safety record

FDA approved Allergan Botox Cosmetic has an outstanding safety record for its use in facial cosmetics. I concur with most of the postings from my colleagues. Experience and an understanding of facial anatomy is the key in terms of minimizing the chances of undesirable results. A droopy eyelid can occur if Botox treatment to the glabellar area (corrugator muscles - located medially above your brow) involves migration of the medication to effect other muscles outside your treatment zone. ... more
C. Bob Basu, MD

Houston Plastic Surgeon

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