I Received Botox the Morning Prior to Conception. What Are the Risks?

I received botox (eyes/forehead) the morning prior to conception. I am now 6 weeks pregnant. What are the risks to my baby?

Doctor Answers 8

Risks to the baby of receiving Botox injection prior to conception

We don't know what effect any cosmetic procedure done during pregnancy may have on the baby, so it's not recommended that a woman who is pregnant or trying to become pregnant have any such procedures done.

But if it happens accidentally, what do we do? We can analyze the risk of anything bad happening.  In your case, I don't believe there would be any harm to the baby if you had Botox injections within hours before conception.  Here are some facts to support this:

  • After fertilization (sperm entering the egg), the embryo spends about a week swimming around the uterus prior to implantation and establishment of a blood supply from mother to baby.
  • The very primitive beginnings of a nervous system in humans start forming around week 2 after conception.
  • Botox works by binding to a receptor molecule on a motor nerve cell (a nerve cell that sends a signal to the muscle to contract) and after being internaized by the nerve cell, preventing the release of a neurotransmitter (acetylcholine, in this case) from the nerve cell into the junction between the nerve and the muscle.  The actual nerve cells that would be affected by the Botox would not be formed for several weeks after your Botox injection took place.
  • Also, more than 90% of Botox molecules are ireversibly bound to their site of action within 1-3 hours after injection, so the chances that there will be any molecules swimming around even several hours later are exceedingly small.

Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Congratulations on your pregnancy.

There are no known risks to the fetus when a mother receives cosmetic botulinum toxin prior to conception. This has become a very common issue and this questio comes up frequently on this forum. There is a tiny study of woman who were pregnant and received Botox. There is never going to be definitive studies on this question because the medical ethics to do justify undertaking such a study. While the risk of harm seems very low, possible zero, cosmetic Botox should not knowingly be administer to pregnant women. Using it for medical reasons is a different matter that must be carefully weighed. I suggest speaking with your obstetrician and consulting a neonatologist if questions remain.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Botox during Pregnancy

Since Botox studies on pregnant women are not done, we do not know the exact risks to the fetus.  Therefore, Botox is not recommended during pregnancy.  

However, in my personal opinion, it is very unlikely, if not improbable that  the very small amounts of Botox that we use to inject into your face (where it attaches locally to facial muscle receptors) is likely escape this area and travel to a distant developing embryo in any appreciable amount, as to cause harm to the developing embfryo.  But, please tell your OB, good luck and congratulations on your pregnancy.

Robert Strimling, MD
Las Vegas Dermatologist
4.3 out of 5 stars 9 reviews

Botox and pregnancy

Thank you for your question. I would not worry too much if you had Botox and found out you were pregnant. Botox works locally where it was injected and the dosing is very small. The makers of Botox would never consider sponsoring a study to see the safety of Botox during pregnancy or breast feeding as it would be too risky for them. Likewise, for physicians. I generally provide reassurance for situations like yours and I do recommend that you stop any future injectable treatments until either the baby is born and after breast feeding. I would also let you OB know that you had a Botox treatment during pregnancy so they are aware.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 38 reviews


First off, congratulations on your pregnancy! While the fetus is only in the early cell stages, there shouldn't be any complications. I always recommend telling your OB that you had botox/dysport the day before you conceived.
Best of luck to you!


Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 86 reviews

Botox Before Pregnancy?

Hi Betsy.  We're not sure that we can add much to the very comprehensive answer made by Dr. Altman other than to say that we believe you should try not to lose sleep over this.  That is not meant to minimize your concerns but rather to help you feel better about the situation.

Although there are no studies involving pregnant women or women trying to get pregnant that are also using Botox, the chance of the Botox making it to the fetus would be exceedingly low based on the localized nature of the product.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Botox injections prior to conception

Within 20 to 90 minutes after Botox is injected, botulinum neurotoxin type A can be detected inside the motor nerve endings. Therefore the muscles and nerve endings take up Botox very quickly before it can spread far from the injection site. I tell my patients they are free to do anything they choose 1 1/2 hours after their injections. This would include conception.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Botox and Pregnancy

Dear BetsyBetsy,

Although we don't know the exact risks with botox and pregnancy, I think that you will be fine. I would never recommend botox during pregnancy, or while breast feeding. However, having botox just before you conceived is unlikely to affect the fetus at such a very early stage. If you think about the mechanism of Botox, it works on the receptor complex between the nerves and the muscles. While your fetus is only in the early cell stages, there shouldn't be any interactions. I would recommend that you tell your OB that you had botox the day before you conceived, but I am hopeful that it won't affect the development or health of your baby. Good luck and congratulations on your pregnancy.

Jennifer Reichel, MD
Seattle Dermatologist
4.5 out of 5 stars 42 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.