In light of a recent incident where a female patient had passed away after a cosmetic treatment, there have been speculations and fear-mongering regarding the aesthetic treatments of Botox in Singapore. From news headlines, it seems to suggest that Botox is likely the cause of death even though investigations are still ongoing.

It is better to objectively discuss the safety issues and facts about Botox, which is a highly common aesthetic treatment in Singapore, instead of jumping into conclusions and causing unnecessary worry about undergoing aesthetic treatments including Botox.

What is Botox or Botulinum Toxin?

Botulinum toxin is a neurotoxic protein, derived from the bacteria Clostridium botulinum. The terms Botox and Botulinum toxin are not interchangeable, contrary to popular use of them as seen in media. Botox is only one of the common brands of Botulinum toxin approved by US FDA and Health Sciences Authority (HSA) Singapore for use. There are other commercial brands namely Dysport and Xeomin that are also used by doctors for treating dermatological conditions.

Since botulinum toxin is a neurotoxin, is Botox still safe?

It is true that it is the same toxic that causes botulism, a life-threatening condition of food poisoning. For cosmetic treatments, however, it is used in very small doses which are considered safe, to treat skin concerns like temporary smoothening of wrinkles, jaw slimming, and therapeutic conditions such as severe underarm sweating.

To be used as a medicine, there are strict manufacturing controls and standards put in place to ensure the safety of patients and the efficacy of the product. How Botulinum toxin is produced involves multiple steps of extractions and purification, resulting in a reliable, consistent and effective medicinal product.

How does botulinum toxin function in aesthetic treatments?

It is injected in very small concentrations to the targeted area on the face or body, and works by blocking nerve transmission in nearby muscles, therefore paralyzing them and reducing their movement. For example, to treat forehead wrinkles, a botulinum toxin injectable will be administered to the forehead area so the injected muscle can no longer contract, causing wrinkles to soften and relax, while also preventing new ones from forming.

What are the side effects and how serious are they?

As with any other drugs, there are risks for potential side effects of botulinum toxin injections. Common side effects include mild pain, bruising and swelling at the site of injection, headache, temporary muscle weakness and flu-like symptoms. There may also be unintended effects on the area of injection such as uneven facial expression with droopy eyelids or lopsided smile, which will last temporarily.

In rare cases, botulism-like symptoms may be experienced such as vision problems, difficulties in breathing, speaking and swallowing, and loss of bladder control. Seek immediate medical attention when these occur.

Because the effects of Botox will remain localised in the area and do not spread all over the body, the chances are extremely low for Botox to spread to the heart and lung muscles, causing cardiorespiratory failure. There is also a possibility of Botox allergy, which causes mild reactions like itching, to an anaphylactic reaction where the airways become constricted, and blood pressure and heart rate will spike, shutting down the circulatory and respiratory system. If an allergy is suspected once a patient is exposed to the trigger, in this case, Botox, they will be warned against undergoing further injections of botulinum toxin.

What can you do to ensure your safety with Botox?

You should always go to a qualified and experienced doctor to administer the Botox treatment. Talk to your doctor and enquire on the approved brand of botulinum toxin injection they are using. Proper consultation is important to help assess your suitability for the treatment and learn about the risks and side effects. Inform your doctor regarding any medical condition such as epilepsy or asthma, and medications you are currently taking which can trigger an adverse reaction upon botulinum toxin injection.

Botox treatment is available in our clinic. If you wish to seek more details on our wrinkle treatments or other treatments available such as face fillers in Singapore.