100 units jaw Botox before I found out I was pregnant?

Question

I had 50 units of Botox for my jaw(25 units each side), then had to go back 2 weeks later for another 50 units, for a total of 100 units. I wasn't expecting to be pregnant but missed my period and turns out I am pregnant...I would've been 3 weeks and 5 weeks the two times I had Botox. I am terrified as I read a report about Botox causing blindness/deafness. What can I do? Should I be worried? I also read cosmetic doses should be fine but is 100units considered a cosmetic dose??

Megan Deacon-Casey, MD · Answer

Kaushiro,
Studies of botulism toxin A injection in pregnant women/animals are limited; however, these studies suggest that botulism toxin A does not cross the placenta, perhaps due to its large size. 
I would consult with an OBGYN for close monitoring and advice. 
Best of luck.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question kwills. 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.Botox can be placed in the masseter muscle in
the lower face to contour the lower face and address pain associated with TMJ.
In this area 20-40 units of Botox are used per side. Depending on the reason
for the enlargement of the muscle, permanent results may be achieved. For
example, some people have a habit of grinding, clenching, or biting their teeth
subconsciously. Often times this happens in their sleep when they are not aware
of it. Botox placed in this muscle will relax the muscle and the grinding,
clenching, and/or biting will decrease. This will reduce the size of the muscle.
If the brain gets accustomed to this and the person stops grinding, clenching,
or biting, then the muscle will not become enlarged or as enlarged again. However,
if the habit starts again, the muscle will likely get larger.The safety record of Botox is well established.
The product has been used for over 20 years for a variety of treatments with
minimal side effects. Botox is amongst the safest treatments for treating
facial wrinkles.However, 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.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 as described above. 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.It is important to understand that any female of child bearing age who is sexually active has the possibility of being pregnant. We discuss these risks with patients before any treatment. If I had a patient in a situation such as this described I would tell her that while it is unlikely that there will be any detrimental effect from a Botox treatment on a fetus, the truthful answer is that we do not know.Please consult with a doctor for specific
recommendations. Good luck!

Beata Danek, MD · Answer

Botox should not be used in pregnancy, but there are many women that don't know they are pregnant when they use it. There is no way to know for sure if it affected your baby. There are very limited studies available, but most of them show no harm to babies or moms. Hope for the best, try to find peace, stress can cause more harm than Botox.

Drew Varano, MD · Answer

Botox is a category C drug during pregnancy meaning the effects are unknown . You can not do ethical studies on pregnant women to find out its effects while pregnant . Only animal studies and rectroactive observation studies in cases such as your situation . Botox has been used for over 30 years and the majority of  users are fertile women , so your situation is not extremely unique and Botox remains a category C drug . If a known link or danger was indentified it would be labeled category D , which it hasn’t in the last 30+ years . The dosage of Botox issued was not extremely high considering it is used in higher dosages  for other purposes. Your motherly instincts for cause of alarm are natural but odds are everything should be fine and best wishes for the rest of your pregnancy .

Ramtin Massoudi, MD - Account Suspended · Answer

Hi Dear
Usually we do not use Botox if pregnant. In this situation follow up with your OB/GYN and make sure you have Ultrasound to make sure everything is fine
Thank you
Ramtin Massoudi, MD

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100 units jaw Botox before I found out I was pregnant?

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Answer: Botox and pregnancy

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