How Safe is Botox?

As with any medication there can be side effects. These side affects will vary depending on the dose, site and the experience and training of the person injecting the Botox. A complication might be some mild pain or tenderness or slight bruising. It is important to seek an injector with the right training and expertise to assure that the correct dose of Botox is injected and that the Botox is injected into the correct muscle.

Botulinum toxin was first isolated in the 20s, was first used therapeutically in 1968, and became approved in 1989 for eye issues. It has been used heavily for cosmetic use since 2002, and it was the first aesthetic drug ever approved.  All that is to say...it has a lot of safety data behind it. Recent evidence (coming out this week) proves that botulinum toxin does NOT enter your brain as it's distant cousin tetanus toxin does, which is where that theory came from. 
Botox, Dysport and Xeomin are the 3 botulinum toxins approved for cosmetic use in the US. They all work in the same way, at the presynaptic terminal blocking the release of acetylcholine - making the nerve temporarily unable to communicate with the muscle. It is broken down as a protein in our body with liver metabolism. Effects are temporary, and repeated use serves to take tension off of your skin, relaxing lines and wrinkles.To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.
Cameron Chesnut
#realself500 Physician

Hi Gale,

We think the study you reference is related to animals and not humans. The injection sites and doses for this study are different than for the Botox you would receive. Botox has been studied and used extensively for years and has a safer profile than the common aspirin.

Periodically we have patients feel light headed and nauseous during and after injections. While we have not determined if this is related to anxiety, pain or some other issue, we do recognize that it occurs sometimes. Patients recover from this fairly quickly after resting for a few minutes.

I think you’re referring to an animal study and not humans. Botox is very safe as it has been used for more than 30 years at high doses for neurology patients, much higher than that used for cosmetic purposes.
It is possible that if some Botox got in to a blood vessel that you might feel nauseated, or it is the technique of pain management during the delivery of the product that can cause this.

Botox has been in use for some 20 years, with millions of injections performed and its safety record is one of the best. Your question is a good one though. The report to which you are referring caused quite a bit of consternation so it is good to set the record straight. It was a study done on rats, not people, in which botulinum toxin injected into the face appeared in trace amounts in the brain several days later.
The type of botulinum toxin was a veterinary grade, and is what is called "uncomplexed" which means that it is a much smaller molecule than the type used in Botox. Smaller molecules are much more likely to migrate. Further, the dose used was about 150 times greater than what would be used in people, and despite all that no adverse effects were noted. I think your nausea reaction is unrelated, as that can happen after any type of injection.