Cystic Acne, Acne Scar Removal

Under The Spotlight: Clarifying The Grey Areas Of Botox

As with any medical substance or drug, there comes a list of risks and benefits. The recent death of a 32-year-old property agent in Singapore who went into cardiac arrest shortly after receiving Botox treatment has caused apprehension amongst the public in regard to this popular cosmetic procedure. This has brought unnecessary attention of Botox as a fatal and risky treatment – creating a rift in an otherwise, data-driven and well-researched cosmetic surgery.

In order for us to clarify the grey area and come to a conclusion, here is a quick recap of what Botox is, and how is it usually administered in cosmetic surgery circumstances:

Botox Simplified

Botox first made its appearance to the public in 2002, when it officially obtained the Food and Drug Administration’s (FDA) stamp of approval for cosmetic uses. In essence, Botox is comprised of a neurotoxin called Botulinum Toxin, which is a substance that is extremely potent in higher dosages. Excessive usage can lead to paralysis, respiratory failure and a potentially fatal condition named Botulism.

What makes Botox work so well for preventing wrinkles and giving the appearance of smoother skin is due to its effect on the nerves of the muscles that prevent it from moving. In order to make it safe for Botox treatments, doctors have to undergo a critical preparation stage in order to dilute and purify the substance before injecting it into a localized area.

Botox is a rapidly growing industry not just in Singapore but across the globe. In fact, the global Botox market is set to reach USD10400 million dollars by the end of 2025, growing at a rate of 12.5% from 2019 to 2025.

Botox is just one of the brands of Botulinum Toxin that is approved by the FDA and Health Science Authority (HSA) in Singapore. As it is recognized as a medical procedure, Botox can only be administered by registered doctors in licensed clinics around the island.

The Price Of Beauty

 The question is: if Botulinum Toxin is dangerous, why is it that it is still used in cosmetic treatments?

As mentioned, Botulinum Toxin is largely “watered down” before using it on patients. Compared to the risks of plastic surgery, Botox is considered of fairly low risk, which is why an estimated 3 million patients continue to undergo the procedure each year.

In light of the recent death of 32-year-old property agent Miss Lau Li Ting, it is only fair that we paint a bigger picture of Botox deaths reported worldwide. In 2008, the FDA issued warnings in regard to Botox after the treatment claimed the lives of 16 people. Fast forward to 2018, a 52-year-old banker in Hong Kong unfortunately passed away after receiving a total of 16 Botox injections in her jaw, chin and above the eyebrows. An important thing to note is that upon closer examination, none of the cases shows concrete evidence of whether the involved parties have passed directly due to Botox, or whether possible underlying conditions could have come into play. 

Clarifying The Grey Areas Of Botox

While there has been plenty of research done to support the use of Botulinum Toxin in the cosmetic and medical industries, the grey area is the fact that everybody, or every body is different.

In fact, Botox is currently the most widely researched and studied treatment of its kind, with over 500 peer-reviewed articles in scientific and medical journals discussing its safety and efficacy. Since 2009, the FDA has also required Botox to carry a “black box” – ensuring the strictest standards in the labelling of the drugs.

What’s more, Botulinum Toxin has been used for over 50 years in the medical industry – having proven highly successful in treating problems such as excessive sweating (hyperhidrosis) and alleviating the symptoms of chronic migraines. Higher dosages of Botulinum Toxin have also been used on children in order to treat ticks and muscle spasms with positive results. In fact, an article published in the Medical Hypotheses journal states that the substance shows great potential as therapy for a huge range of conditions including tumors, asthma, depression and even cystic acne.

Despite notes from the FDA warning that Botulinum Toxin may migrate up to 3 centimetres from where it was injected, the recommend cosmetic doses (typically less than 100 units) is much lower than the lethal dosage needed to cause death. (2,500-3,000 units) Thus, causing death by Botox is in fact, extremely rare. In most cases, severe side effects have never been linked to dermatologic use, with majority instead coming from therapeutic cases in the presence of other key factors – higher dosages, injections in the wrong areas and other underlying medical conditions that a patient might have.

Therefore, concluding to say that Botox is poisonous and fatal is misguided and false. With the data delivered, one thing can be said for sure – Botox risks are largely minimized when done with a safe and experienced, licensed medical doctor. 

Two Critical Roles At Play 

With all that terrifying news headlines, there is still light at the end of the tunnel.

On one hand, doctors and practitioners need to be steadfast and uncompromising when it comes to implementing best practices – including getting licensed and only using HSA-approved brands for injections.

On the other hand, patients need to be 100 percent transparent with their doctors, sharing with them their full medical history and listing down all allergies during the initial consultation. Inform the doctor to let him or her know if it is your first time doing Botox, or if you have gone for another injection in the last 4 months.

Most importantly, be aware of the symptoms such as having problems swallowing, speaking or breathing that will require immediate medical attention. Even symptoms such as drooping eyelids, double vision or muscle weakness can be clear signs of something more serious.

There can no longer be a laidback attitude when trying to come out of the grey area –

at The Clifford Clinic, we highly respect our roles in the medical aesthetics industry, whether it is Botox or smaller procedures such as acne scar removal and acne scar treatment – and we believe you should too.

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