BOTOX ® is the abbreviated name for botulinum toxin, a neurotoxic protein that is primarily used in cosmetic dermatology for the treatment of wrinkles, facial creases and severe brow lines.? BOTOX ® is also used to treat a wide range of other medical conditions including excessive perspiration (hyperhidrosis), some forms of incontinence, Multiple Sclerosis and other spastic muscular conditions.?
Although BOTOX ® has increased in popularity in recent years, there are still a number of risks and complications that can occur throughout the procedure and even during the recovery period.
Contamination
Contamination may occur in the process of manufacturing BOTOX ® or in the process of reconstituting the BOTOX ® powder for use.? During the manufacture process, certain harmful elements may not be eliminated and as a result, the effects of the BOTOX ® on the patient cannot be judged and can precipitate health risks. These risks are idiosyncratic to the patient.
Risks Related to Administration of BOTOX ®
One risk of the administration of BOTOX ® is that the toxin may be inadvertently delivered intravenously (into the veins) instead of subcutaneously (under the skin).? Should this happen, the effects are immediate and dramatic, the most serious of which being general paralysis of muscles throughout the body.? This generalised paralysis can affect heart muscles, the bowels and breathing muscles.
Another potential complication of BOTOX ® is that it may inadvertently affect the phrenic nerve (a nerve in the neck) when being injected into the neck muscles of patients suffering from Torticollis or related spastic muscle conditions.? Should this happen, the diaphragm ? the main muscle that aids breathing ? can become paralysed and cause severe breathing difficulties.
Risks Related to the Natural Action of BOTOX ®
When administered to the face, BOTOX ® may cause blepharoptis (drooping of the eyelids), as it would cause the paralysis of the muscles that elevate the eyelid.? In addition to this, when used to treat urinary incontinence by injection into the bladder, there is a potential risk of 1 in 10 to 1 in 4 of the treated patients requiring catheterisation due to urinary retention. Occasionally during the process of injection into the bladder, the point of the injecting needle could perforate the bladder wall and the bowel wall may be injected with BOTOX ® . This may results in temporary paralysis of parts of the bowel leading to indigestion-like symptoms such as bloatedness, nausea and vomiting.
Immunological Risks and Complications
BOTOX ® is a strong antigen. When injected, the body reacts by forming antibodies to the injected BOTOX ® . Occasionally, an idiosyncratic reaction can occur. This is a reaction that cannot be predicted and may consist of symptoms such as perspiring, rapid pulse, facial swelling and urticaria (rash and itching). Swelling of the tongue may lead to choking of the airways.
The beneficial effects of BOTOX ® tend to wear off with time as the substance is degraded by the body. Therefore, it usually has to be repeatedly administered. There is therefore the risk of chemical tolerance, where the body requires increasing doses of BOTOX ® in subsequent injections to produce the same effect.
Before considering the use of BOTOX ® , it is important to take into account these potential risks and complications and adequate precaution taken to prevent them or minimise their effects, should they occur.
