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Botox Munich - Information on safety when using Botox (botulinum toxin)

From Dr. med. Wolfgang Thriene

In the media, the use of Botox has often been viewed with critical voices or even the target of sensational reports. If you look into these reports, it often becomes clear that ignorant journalists, with no medical background whatsoever, have reported cases that were not treated with Botox at all. An example of this is the exaggerated filling of the lips, which was then referred to in some magazines as the botox lip, without botox ever being involved! We also like to show pictures of film stars who are allegedly “victims of a botox treatment” but who have actually undergone an unsuccessful facelift.

If you want to realistically view and evaluate the side effects of a Botox application, then facts must first be created:

Botox- the poison

It is true that botulinum toxin is a product of the bacterium Clostriduim botulinum. It is wrong that this is snake venom or another animal venom, as is often falsely claimed. It is important to know that the use of poisons has a long tradition and that almost all modern drugs act as poison if they are used in the wrong dosage. The poison of the deadly nightshade (atropine) or the foxglove (digitalis) are important heart drugs. Poisons such as bee venom or dilutions of snake venom were also used regularly by doctors in antiquity. Aspirin acts as a poison when you take it in boxes. There is therefore no need to be afraid of the poison botox when used in aesthetic medicine.

Would you like to be treated with Botox? Please make an appointment for a consultation!

Botox against wrinkles

The effectiveness of botox against wrinkles was discovered accidentally by a Canadian ophthalmologist (Dr. Carruthers) while treating patients with botox for strabismus. It is important to know that very small doses are injected in a targeted manner and therefore the whole body is not flooded with Botox, as can be read in some gazettes.

How dangerous is botox to correct wrinkles?

In order to poison or even kill a person, 30 to 40 ampoules of the drug would have to be administered at once. If you take into account the price of an ampoule, it would be a very expensive undertaking. There are similarly dangerous substances that are significantly cheaper and, above all, much easier to obtain. The dose that we use to correct wrinkles is 100 to 1000 times lower than the dose that would be required for fatal poisoning. Accidentally injecting a double dose into a patient while correcting their wrinkles could lead to severe mobility restrictions for 6 months, but certainly not to death. If a digitalis patient accidentally doubles their dose, it can lead to life-threatening disorders of the heart, which can be fatal. This shows that Botox is by no means the dangerous drug, as ignorant journalists keep making us believe. So far, there has been no death from the use of Botox in the field of aesthetic medicine. There were cases in which more serious side effects occurred in the field of the neurologist on seriously ill patients in whom very high doses were used.

What are the side effects of using Botox?

As with all medications, there can be side effects when using botulinum toxin. Since the drug has to be injected into the muscle, the side effects typical of injections can occur. If small vessels are injured, bleeding can occur, but this disappears after a few days. Bacteria can migrate through the existing branch ducts and cause infections. Since the area to be treated is extensively disinfected in advance in the doctor's office and sterile disposable material is used, this risk is very low. It is increased if the patient does not follow the advice given by the doctor after leaving the practice, i.e. rubs dirty fingers around the injection area and thus introduces bacteria.

Since the toxin needs a few hours until it is firmly bound to its place of action, one should not lie down or work stooped for at least 3 hours after a Botox injection. The aim is to prevent the toxin from reaching regions where it is not wanted and where it could cause problems due to changes in position. Activities that greatly increase blood flow, such as sports or the solarium, should also be avoided. Otherwise, the active ingredient could be transported to another location by an increased blood flow.

In rare cases, mild headaches are described after the use of Botox, but they go away quickly.

The following side effects can occur depending on the area treated:

Cross wrinkles on the forehead: If the dosage is too high or the patient is particularly sensitive to the drug, the eyebrows may temporarily drop. Double vision or a disturbed eyelid closure were observed extremely rarely.

Frown lines: This can lead to slight swelling or a sagging of the inner parts of the eyebrows. A drooping of the eyelids has also been observed in very rare cases.

Laugh lines: By influencing the facial muscles and their relaxation, the lymphatic drainage is also indirectly influenced. In unfavorable cases, this can lead to swelling around the eyes

Injections in the mouth area: Here, excessive doses can temporarily lead to drinking and speech disorders. These symptoms usually go away within 2 weeks.

In all regions, incorrectly placed injection points or excessive doses can result in asymmetries, which then have to be corrected with further injections

The experienced practitioner knows the possible risks and side effects of botox therapy exactly and can avoid them in most cases. It is important to note that the patient does not have to despair if side effects occur, since all effects and side effects of Botox are temporary in nature.

What are the long-term side effects of Botox?

There are numerous studies on the long-term side effects of Botox, all of which come to the conclusion that no long-term side effects are known to date. The alleged migration of Botox into the brain, which is exaggerated in many reports, also turns out to be unsustainable when viewed scientifically.

Which patients shouldn't be treated?

Even if in our practice near Munich the wish of pregnant patients for a botox treatment is expressed again and again, we will not comply. The legislature has clearly regulated that only certain medications may be administered to pregnant women. The same applies to breastfeeding. It is therefore advisable to answer truthfully the questions about pregnancy and breastfeeding that are asked by the doctor as part of the consultation. Botox treatment will not be given to patients who are given certain antibiotics, if they have certain muscle and nerve diseases or if there are acute infections in the treatment area.

Risk of loss of facial expression or formation of a mask face

Botox has a smoothing effect on the skin by relaxing the facial muscles. This effect is dose-dependent and can range from gentle relaxation to complete freezing of facial expressions. In the USA, many movie stars have the motto that being wrinkle-free comes before facial expressions. In some inglorious examples, this has led to the term mask face or botox face. In Europe, many lower doses are used than in the USA and more emphasis is placed on the naturalness of the result. Therefore, there is no need to worry about a mask face when turning to an experienced doctor for a botox injection.

Here you can find more information on the use of Botox in wrinkle therapy. You can also find more information on the clichéd use of Botox on our Botox Munich page.

Final assessment of the safety of Botox

In the hands of the experienced user, Botox can be classified as a safe drug. There is experience from a huge number of treated patients. It is currently not foreseeable that long-term side effects are to be expected. The dangers lurk not with the drug, but with dubious or amateur use by inexperienced users or those who use unapproved preparations. Therefore, you should contact a long-time experienced user for a botox treatment.

additional Information

We have been working with Botox in our practice for over 10 years. For a counseling on Botox Munich, please contact Dr. Thriene.