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Q&A: Is Botox Dangerous?

Posted by Dan Narsete on

Question & Answer: How serious are the potential negative side effects of Botox? What percentage of people experience a side effect?


Botox is probably one of the most popular treatments in the aesthetic industry. It’s also a household name, which leads to questions like the one posed. As always, let’s breakdown what Botox does, why it’s used, and what dangers, if any, it has.

What is Botox?

Botox is a brand name trademarked by Allergan, the first company to come out with the drug. A neuromodulator (say that five times fast) is a substance that disrupts the signals sent from your brain to muscles telling them to move. These neuromodulators are injected into muscles to slow or stop them from moving. It is temporary and usually lasts anywhere from 3-6+ months depending on the dose and how much is used. FYI, men tend to have larger facial muscles and process neuromodulators faster than women. Because of this they usually need more frequent injections and larger doses to achieve the same results. 

Why should I use it?

Wrinkles are divided into two parts. Skin laxity, which results from sun damage and natural aging, causing skin to droop or lose its elasticity. The second part is muscle memory; the more they move the more wrinkles we will develop. Neuromodulators help to stop this process. Less movement=less wrinkles. Over many years, your facial muscles will build up around the expressions you make and thus causing wrinkles. Don’t begin to frown over it--we don’t want to make it worse--it’s a normal part of life, nothing to worry about. As we all eventually age this process will occur. So, if you want to give your face the 1:2 punch combo, a neuromodulator such as Botox should become a semi-annual event for you.

Is it dangerous?

According to the American Society of Plastic Surgeons as of 2016 neuromodulators such as Botox and Dysport (Galderma) have grown 376% since 2000 with over 7+ million injections done in 2016 alone!!! Since it’s popularity has skyrocketed in the past few years, we asked Plastic Surgeon Dr. Thomas Narsete, MD to find out what the biggest concerns are using Botox. According to Dr. Narsete, “although rare, it is possible for Botox to migrate and develop into an eyelid ptosis, or drooping of the eyelid, however there are precautions patients should take such as staying upright (not sleeping or laying down) for at least four hours following a treatment. People will occasionally have headaches following injections.” On the Allergan website, there is a long list of possible side effects (if you want to read all of them click here) with the two largest being eyelid drooping 3% and headaches 9%. Go figure. After doing some research, there are over 3,000 studies on Botox alone. Keep in mind the report on the Allergan website was done only one a single study and is not the total number of issues across the board. However, with 7+ million treatments per year, it seems like a pretty safe treatment.

What to expect

Like anything, make sure your injector knows what they are doing. There are several people that inject and probably shouldn’t. This isn’t intended to scare you, rather to inform you on making the right decisions. Ask around and make sure the practitioner is certified by one of the injectable companies (Allergan/Botox, Galderma/Dystport or Merz/Xeomin) and either practices under a physician’s supervision (registered nurse) or is a licensed physician themselves. When getting the treatment for the first time, you will feel a small pinch where they inject the toxin. For a few hours or so, you will probably have small red bumps where the injections were done and the area will likely be a little tender for a few days. Keep in mind it might take a week+ for the toxin to subdue the muscles, which is normal. Quick tip: try putting an ice pack or frozen popsicle on the area you plan on having injected (such as your forehead) for a few minutes prior to getting the injection. The cooling will help numb the nerves and make the experience that much better.

Where to go from here

Hopefully this has answered your questions about Botox or at least informed you enough about the process. Albeit rare, complications do happen. If you follow instructions the likelihood you will have an issue is slim to none. Here are the three main companies and their provider links so you can find a licensed provider:  Botox, Dysport, Xeomin.


To getting rid of wrinkles,


Team Reflect

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