Munson Health
Botulinum Toxin Injections -- Cosmetic

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by Aaron S

(Botulinum Toxin Type A; Botulinum Toxin Type B; Botox Injections)


Possible Complications

Complications are rare. When they occur, they are temporary and mild. Side effects are related to the site of injection. For example, if injections take place near the eyes, there may be complications with eyelids or the brow line.
Temporary issues may include:
  • Redness
  • Bruising
  • Stinging around the injection sites
The following are less common reactions. They are generally mild and do not last long.
Other complications that may occur include:
  • Excessive weakness of the muscle around the eyes—can cause drooping of the eyelids or obstruction of vision
  • Difficulty swallowing—can occur in patients receiving injections in their neck
FDA Public Health Advisory for Botulinum Toxin
There is a risk that the botulinum toxin could spread beyond the injection area. This can cause botulism symptoms, including difficulty breathing and death. These symptoms appear to be more common in children with cerebral palsy who receive the injection to treat spasticity. The warning is for Botox , Botox Cosmetic, Myobloc , and Dysport. For more information, please visit: .
  • This procedure may worsen nerve or muscle disorders, such as:
The toxin can also interact with medications, such as antibiotics. Tell your doctor about all of the medications that you are taking.
You should not have botox if you:
  • Have an infection or inflammation in the area where botox will be injected
  • Are sensitive to the ingredients in botox
  • Are pregnant or breastfeeding


American Academy of Dermatology

American Society of Plastic Surgeons



Canadian Dermatology Association

Health Canada



Ondo WG, Gollomp S, Galvez-Jimenez N. A pilot study of botulinum toxin A for headache in cervical dystonia. Headache. 2005;45(8):1073-1077.

Ward A, Roberts G, Warner J, et al. Cost-effectiveness of botulinum toxin type A in the treatment of post-stroke spasticity. J Rehabil Med. 2005;37(4):252-257.

11/4/2009 DynaMed Systematic Literature Surveillance FDA gives update on botulinum toxin safety warnings. US Food and Drug Administration website. Available at: Updated August 3, 2009. Accessed September 3, 2014.

10/1/2013 DynaMed Systematic Literature Surveillance US Food & Drug Administration. FDA approves Botox Cosmetic to improve the appearance of crow's feet lines. US Food & Drug Administration website. Available at: Published September 11, 2013. Accessed September 3, 2014.


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