Botox side effects - how can I avoid bad Botox side effects?

Botox should be fresh and kept refrigerated from the instant it arrives at the dermatologist’s office. Botox does deteriorate over time. A provider who does not complete very many Botox treatments per week may have Botox on hand that has lost its potency due to aging and deterioration.

So, select a dermatologist who provides Botox regularly. With so many providers offering Botox injections these days, there is a definite difference in provider skill levels. If you do not see satisfactory results within 2 weeks of treatment, it is possible that the Botox was incorrectly reconstituted with too much saline, or it is possible that not enough Botox was used at each site, or perhaps it was injected in the wrong sites, or was injected improperly. Of primary concern, a skilled and honest physician should be chosen for your procedure.

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 reported death in a CP child who subsequently died of pneumonia. These patients are receiving Botox in doses that are many, many times larger than the small dose that is used for cosmetic treatments. Botox is used in these unfortunate CP patients to relieve muscle spasms in their legs, arms, and necks. Even the physicians who use Botox to help CP patients are saying that the overdoses are likely from injectors who don't know how much to use and are using the wrong dosing of the drug.

A few years ago there were unscrupulous labs and injectors who, respectively, manufactured and injected botulinium toxin that was for "experimental animal use only." Four people, including the injector, ended up in the ICU for many months. One must make sure that the Botox they use is from Allergan corporation, or from the company that manufactures Myobloc.

This news is a reminder that Botox is a potent drug and that injecting it is a medical procedure that should be performed by a board-certified physician in a medical setting, not in a salon, spa, hotel room, or friend's house.

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 Botox per treatment area and have not administered more than 40 Units at a time.

I would stress Dr. Caschette's sentiment - it is easy to administer Botox; what is difficult is to deal with any possible complications. Be sure to seek treatment from a facility where a trained, experienced physician is either doing the procedure or is readily available in case of problems.

• Botox treatment is a medical procedure. Always seek treatment from a physician experienced in Botox injections. Physicians are best equipped to deal with bad reactions to Botox, the most worrisome being an allergic or anaphylactic reaction.

• Ask to see the Botox Cosmetic vial before injection. It’s small with a purple and white label. There’s a hologram which spells out “Allergan” on the label.

• Make sure before and after pictures are taken to evaluate your response. I wait 10 days to take “after” pictures.

• Make sure you read and follow your Post-Procedure Botox Instructions from your doctor. Hey- It’s Your Face! Maximize your chances of a great result by making sure a Medical Doctor with experience is performing your injections personally.

First and foremost, do your research. When finding a facility to perform your Botox treatments, ask the following questions:

1. Do you receive your Botox directly from Allergan? (authentic Allergan Botox vials will have a hologram and Lot Number)
2. Who performs the treatment and how are they trained?
3. Do you have a Medical Director directly involved with the facility?

Steer clear of "Botox parties," as this is very risky, and there is no way to verify the credentials and training of the injector. In California, it should be noted that the Board of Registered Nursing requires that a "good faith exam" be carried out by an MD or advanced practice practitioner before the first treatment is rendered.

At our facility, we are in complete compliance of this regulation. Botox treatments can be very rewarding and safe in the right facility. Besides dermatology and plastic surgeon offices, there are many, many other facilities doing this procedure with excellent outcomes.

Never assume that only an MD can provide safe and effective treatments. Registered Nurses have proven to be very passionate about these treatments and have quite a reputation for refining their skills by attending numerous workshops, advanced training seminars and such in order to stay on the forefront of research and newer techniques. Whoever you choose to do your treatments, you may want to ask if they routinely participate in these training modalities.