I got 40 units of Botox during 9-10 weeks pregnancy. Will this harm my baby?

Question

I got Botox one week ago. 40 units in my jaw.  I didn't realize just now I got pregnant, 9-10 weeks currently. I sometime skip my period so I wasn't expecting that I'm pregnant. I was worried and read other question about getting Botox in early stage of pregnancy, but I'm in 9-10 weeks and found out it is a very important period for baby. How does botox harm the baby or will it be okay?

Michael P. Morrissette, DDS, FACS · Answer

There are no studies on the effects of Botox during pregnancy, but I am not aware of any reported incidents or problems anywhere in the world. Generally, we do not inject pregnant women with Botox. However, many patients have been injected worldwide with Botox who were pregnant and were not aware of their early pregnancy. The effects of Botox remain local to the injection site, so it makes sense that there should be no risks to the baby. Discuss your concerns with your OB

Jason Emer, MD · Answer

you will likely not be hurt, although few studies have been performed on women during pregnancy its unlikely that anything will happen since botox is not absorbed into the systemic circulation.  Best, Dr. Emer.

David Yew, MD · Answer

Once an injector knows the patient is either pregnant or breastfeeding - they are discouraged from injecting cosmetic botox.   It's more from a lack of research and a fear of being sued if some unexpected birth anomaly occurs (which is probably not related to the treatment).   
However - to reassure you - both of my children were born normal and my wife had received botox prior to knowing she was pregnant.   It's similar to women who consume alcohol before finding out they are pregnant.   Once you know you're pregnant - you should do everything that is reasonable and safe for the protection of the pregnancy.   A healthy normal pregnancy is never guaranteed even if you do everything "safe".   So I would not worry about the botox at this time.   I would not receive any more injections until after you have the baby and finish breastfeeding.   Also - consult your OB-GYN as well.

Elham Jafari, MD · Answer

Hi and thank you for your question! We generally refrain from doing any kind of cosmetic elective treatments during pregnancy, not because the treatments are necessarily harmful to the fetus, but simply out of abundance of caution and given that we can always wait and do it after the pregnancy or nursing period. Likewise, there have been no studies performed in pregnant women to assess the safety and efficacy of Botox in this population, but based on the extensive safety data available from treatment in non-pregnant women, and the fact that some patients do end up getting Botox during early stages of pregnancy because they were not aware of being pregnant just like you and no reports of adverse effects have been published from those cases, I wouldn't be worried much at this time. Most of the injected Botox stays in the site of injection and very minute amount generally end up in systemic circulation, and even less amount if likely to cross the placenta, so I don't think you should be worried much about it. Please relax and have a healthy and joyful pregnancy!

Monika Soni, MD · Answer

Even though there are no studies done that I know of  in pregnant women and Botox, Physicians generally refrain from using any kind of surgical treatments or even non invasive treatments on early pregnancy women. If you want this baby then I would encourage you to stick with the pregnancy and I'm sure everything is going to be just fine as the chance of Botox harming your baby's relatively small in my opinion.

Camille Cash, MD · Answer

There is little information known about the effects of Botox during pregnancy.  It should be okay as the product is injected into the muscle.

Anteneh Roba, MD · Answer

Based on available information Botox shouldn’t be an issue. Of course Botox is never used to treat cosmetic abnormalities during pregnancy, but since this after the facts it’s understandably worrisome.

Jacqueline Calkin, MD · Answer

While we do not treat pregnant and breastfeeding women with Botox, I don’t think you need to worry. There is at least one study where several hundred doctors were interviewed about treating patients who later found out they were pregnant. There was NOT an increase in the rate of miscarriage and there were no birth defects. Please don’t worry and congratulations!

Leonard Grossman, MD · Answer

Even though there are no studies done that I know of  in pregnant women and Botox, Physicians generally refrain from using any kind of surgical treatments or even non invasive treatments on early pregnancy women. If you want this baby then I would encourage you to stick with the pregnancy and I'm sure everything is going to be just fine as the chance of Botox harming your baby's relatively small in my opinion. Good luck from New York City

Alex Eshaghian, MD, PhD · Answer

Thank you for your question kim han. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam where the entire medical history is reviewed. However, I hope the information provided here is useful.Although Botox is one of the safest treatments offered, there are some situations where it is not appropriate. The safety and efficacy of Botox treatments have not been determined in women who are pregnant, trying to become pregnant, or breast feeding. There is also no evidence that Botox crosses the placental barrier, but such studies have not been published. While some physicians are comfortable treating women who are pregnant, trying to become pregnant, or breast feeding, in the absence of data I err on the side of caution and recommend that my patients avoid Botox and other such cosmetic treatments until they are no longer breast feeding.If I had a patient with the concern described here I would say that unfortunately there is no evidence on the safety of Botox treatments during pregnancy and I would recommend that she inform her obstetrician about the treatment for recommendations.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
  
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.
  
Please consult with a doctor for specific recommendations. Good luck!

I got 40 units of Botox during 9-10 weeks pregnancy. Will this harm my baby?

Answers (11)

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