What can go wrong with Botox?

The risks of Botox are minimal but include:

1/ Bruising from the injection.

2/The lateral brow peaking. This is comparatively common and is an overactive frontalis muscle pulling the lateral eyebrow too high. The cure is to place a tiny amount of Botox at the apex of the peak.

Botox vs Disport

The market leaders for botulinum toxins are Allergan with Botox and Ipsen with Dysport. Ipsen has received FDA approval for Dysport® (abobotulinumtoxinA) to treat Upper Limb Spasticity in children, excluding cerebral palsy. Botox is so dominant that botulinum toxin treatments are often referred to as Botox treatments.

Galderma has introduced a smaller vial of the same botulinum toxin as Dysport, named Azzalure, previously marketed as Dysport but now available for cosmetic use. Both drugs have botulinum toxin, produced by Clostridium botulinum. Dysport and other botulinum toxin products have a Boxed Warning about potential spread of toxin effects, which can cause life-threatening symptoms like botulism, including swallowing and breathing difficulties. Dysport is contraindicated for patients with hypersensitivity to botulinum toxin or its components, infection at the injection site, or allergy to cow’s milk protein. Dysport's potency Units are specific to its preparation and assay method and are not interchangeable with other botulinum toxin products.

Manufacturers claim their product is superior, but Botox, Dysport, and Azzalure are equally effective. Dysport and Azzalure spread slightly more at the same injection volume, beneficial for forehead treatment but less so near the eyes. A higher dose in a smaller volume is recommended around the eyes. It is important to know which product and which you are receiving for continuity with different practitioners.

1. Avoid rubbing your face for 24-48 hours after Botox injections.

2. Limit sun exposure and photo damage.

The FDA approved twenty units of Botox for frown lines, twenty-four units for crow’s feet, and twenty units for forehead lines.