The Premiere Site For Celebrity Plastic Surgery By A Real Plastic Surgeon

I'm a Michigan-based Board Certified Plastic Surgeon who has been featured on Dr. 90210. The info here is my opinion alone and should not be taken as fact or as medical advice. I've not treated any of the celebrities presented here.

Sunday, January 27, 2008

Safety of Botox

A U.S. consumer group called Public Citizen has recently asked the FDA to reconsider the safety of Botox treatments. They pointed to some 16 deaths following Botox treatments, citing complications such as paralysis of the esophagus and aspiration pneumonia.
Botox is currently the most common medical cosmetic treatment today. According to the American Society of Plastic Surgeons, last year over 4.1 million Botox cosmetic treatments were performed. It is currently FDA approved for treatment of glabellar wrinkles, which are the frown lines between the eyebrows. Any other treatments are considered 'off-label.'
I believe Botox is a very safe treatment if performed in the right hands. Over the past few years we have performed probably 500+ Botox treatments in my practice without a single known significant complication. If it is injected cosmetically for the upper face (where it is most effective), I can't see how someone would get a complication like that mentioned above. The worst that can probably happen is drooping of an eyelid (very rare) or a bruise (somewhat common).
I surmise that the esophageal and lung complications may have resulted from Botox being injected for non-cosmetic reasons. It is currently being used for more indications than can be mentioned here, including TMJ, migraines, and various muscle spasm problems. It's possible that poorly performed treatment for a non-cosmetic indication could result in the bad complications cited by the Public Citizen.

For the article on the Public Citizen, click here.
For the reply by the American Society of Plastic Surgeons, click here.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.


suzan said...

Dr Youn, Can you please tell me more about the new procedure I read about in the news that replaces Botox injections with paralysis via electrical impulse known (I believe) as NoTox? I read that while the procedure is not yet commercially available, the electrical impulse can 'freeze' the muscle for up to two years without rendering other muscles (such as the forehead, when treating the brow)paralysed (i.e. Botox forehead).
I would appreciate your comments on this procedure.

Dr. Tony Youn said...

I am not too familiar with it. I did attend a talk about it a few months ago in Baltimore, but to my understanding it is still experimental. It may be some time before it is being used widely.

Rachael said...

Dr Youn,

I am one of the unfortunate few that can only achieve absolute minimal results from Botox injections. I'm 31, and I began getting Botox in my glabellar creases at the age of 29. Genetics shows a disposition in females in my family to show advanced signs of aging in this region, with minimal signs of aging elsewhere (no crows feet or horizonatal creases).

Despite disappointing results at 3 seperate, Board Certified, Licensed Injectors/Plastic Surgeons, I still am getting far too much creasing in my glabbellar region. My most recent physician has noted that the muscles in my glabellar region run almost horizontal with my eyebrows versus extending vertically to form the classic "11". I've received almost 60 units total, well spaced (timewise) in my most recent session in order to avoid harmful effects of too much Botox, and in an effort to find a technique to hopefully erradicate my ongoing issue with strong corrugator muscles between my brows.

I've continued to receive Botox, despite my frustration since I do see *some* imporvement and I go approximatley 3 times annually. I think the benefit of limited tension headaches and the minimal paralysis of the muscles is better than nothing at all, but I'm still very frustrated with my outcome.

Do you know of any other methods to deal with Botox resistant clients? Any advice or suggestions?

Thank you!