Botox® was approved by the FDA in the late 1980’s for the treatment of spastic muscles of the eyes and soon after the turn of the century it was approved for treating cosmetic lines and wrinkles on the face. It is highly unlikely that they would have approved and injection for cosmetic reasons in there was much concern about serious effects.
When properly used, the inadvertent side effects of Botox®/Dysport®/Xeomin® injections are mild, cosmetic and short-lived like bruising, discomfort at the site of injection and weakening of adjacent muscles. Excess drooping of an eyelid is probably the most common 'serious' complication of neurotoxin injections and can generally be avoided by keeping the injections above the rim of the eye socket when treating the brows, avoiding rubbing the area after the injection and not performing strenuous activity for two hours after injection. Wearing a tight hat soon after the injection can also potentially move the toxin before it is absorbed and should be avoided for about three hours after treatment.
Botox®/Dysport®/Xeomin® injections are not completely without risk and should be avoided in some patients. Those patients with certain neuromuscular disorders such as Guillain-Barre Syndrome should not receive neurotoxin injections because of the potential for exacerbation of their disease. Women who are pregnant or breast feeding should not get neurotoxin injections because it is not well known how these medications could affect a small child or developing fetus and it is unclear if neurotoxins can cross the placental barrier.
Patients who are on serious medications that thin their blood such as Plavix® and Coumadin® can get significant bruising with any type of injection and it is probably not safe for them to stop these drugs for cosmetic treatments and they are being taken for significant medical conditions.
There were reports of several patients who became seriously ill after neurotoxin injections several years ago in Florida by a non-plastic surgeon. Neither Botox®, Dysport® nor Xeomin® was used for these injections. It was a similar drug but highly concentrated and was intended only for animal testing and not human use that was improperly mixed so that these patients received several thousand times the normal dose of neurotoxin. For this reason as well as many others, it is important to see a board certified, reputable plastic surgeon for your Botox®/Dysport®/Xeomin® treatments.
If you have never had a neurotoxin injected before and are a ‘virgin’ patient for this kind of treatment, it is normal to be a little nervous. I strongly recommend avoiding non-physician injectors, as they are generally only taught technique and do not understand the unique necessity of adjusting treatments in some patients to get a good result. Do you really want to patronize a physician who doesn’t have time for you and has a technician perform your injections? I prefer to spend time with my patients and give them my full attention in order to get them the best treatment possible.