What are the risks of Botox?
Botox or botulinum toxin injection for aesthetic
purposes has been the most popular non-surgical cosmetic medical procedure
in the world for years in the United States the other botulinum toxins
available to us are Dysport and XEOMIN as one of the first doctors to
use botulinum toxin in 1993 before he was used for cosmetic indications I can
discuss my experience and how I counsel my patients about the risks of botulinum
toxin in my practice I’m Dr. Amiya Prasad I’m a Board-certified cosmetic
surgeon and Fellowship-trained oculofacial plastic and reconstructive
surgeon I’ve been in practice in Manhattan and Long Island for over 20
years as I mentioned earlier as an oculoplastic surgeon I was among the
first group of doctors to administer Botox to patients for the treatment of
neurologic conditions like hemifacial spasm and been nine essential
blepharospasm in fact I was a division chief at a hospital soon after my
fellowship training and I was the only one at the hospital allowed to use
botulinum toxin if other doctors at the hospital wanted to use botulinum toxin
they had to contact me and to present the request and it was up to me to
approve their use of Botox at the time I was so focused on the numerous medical
and neurologic uses of Botox I questioned how it would be possible that
people would willingly subject themselves to having a neurotoxin
responsible for paralysis and death as in the case of botulism for the purpose
of improving wrinkles clearly the world has more than embraced botulinum toxin
for aesthetic purpose the applications of botulinum toxin for
facial enhancement and even underarm sweating are very well-established
botulinum toxin is not a filler it works by interfering with nerve signals that
go to muscles by blocking the nerve signal the muscle doesn’t contract for
example in a situation where you have deep frown lines the muscles responsible
for these lines are the corrugator and pro serous muscles after botulinum toxin
is administered the lines are diminished since the muscles are not as active this
effect can last about 3 to 6 months in my practice I typically treat people
every 4 months the more common concern I address is a fear of looking overdone
this concern is usually followed by the recitation of a list of famous people
where the patient says looks botoxed or frozen as with any facial enhancement
evaluation I discussed the potential role of botulinum toxin in the context
of other issues which are typically present such as hooded upper eyelids and
under eye bags cheek volume loss and thinning lips I show examples of area
specific treatments such as crow’s feet lines frown lines depressed brows and
downturned lips the effects of botulinum toxin are generally seen at three days
and peak at about two weeks my patients don’t look frozen or fake they just look
better since I see my patients routinely two weeks after injectables I assured
them that I can start conservatively to see how they respond as with any
procedure which involves needles there are some people who have more anxiety
about needles than they do about the outcomes of treatment I offer my
patients topical anesthetic as well as nitrous oxide sedation so they can be
more comfortable people are able to drive after receiving nitrous
our sedation which is commonly used for dental procedures I also used the
smallest needles and my technique has been consistently successful in terms of
patient comfort asymmetries and botulinum toxin affecting non-targeted
muscles inadvertently is a risk asymmetry such as uneven brows can be
addressed with additional placement of botulinum toxin to create a better
violence sometimes a facial muscle can be effected such as in the upper eyelid
resulting in temporary mild ptosis since the botulinum toxin was not directly
placed in this area the effect is caused by relatively low dose which means the
muscle activity typically returns much sooner than the intentionally treated
muscles problems with botulinum toxin and other fillers are often associated
with people thinking that cheap Botox or fillers is a good idea
understanding the minimum cost to the practitioner it’s obvious that a lot of
the typical low cost botulinum toxin is delivered by over dilution of the
product so the effects don’t last as long as they as they should instead of
calling it cheap Botox it is often referred to as expensive water on a more
serious note the product is as good as the practitioner performing the
procedure knowing the muscular anatomy and understanding how to precisely dose
and place it’s truly an art which takes years to develop you can decide how much
your facial appearance is worth investing in I think that I can state
from my personal experience that the risks of botulinum toxin can be
minimized by having the procedures performed by an experienced physician in
an office setting who will be there for you should something unexpected occur I
hope you found this information helpful thank you for your question