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Complications after Botox injections
Last reviewed: 08.07.2025
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Complications of Botox injections include the formation of microhematomas and local pain at the injection site. Temporary relaxation of adjacent muscles due to toxin diffusion may also be observed. The effect on these muscles depends on the injection technique and the dose of Botox. To minimize this side effect, the smallest possible dose and volume of the drug should be used. To accurately place the needle in the most active part of the muscle, we use EMG-guided injection. This allows us to achieve the maximum effect with a minimum dose. Careful injection of small amounts of toxin eliminates or minimizes unwanted weakening of adjacent muscles. If the adjacent muscle weakens, leading, for example, to ptosis, this effect will be temporary. The use of Botox is not accompanied by long-term complications. Muscle biopsies performed on patients after repeated injections did not reveal any signs of permanent atrophy or degeneration. Some patients who have received large doses of Botox (300 U or more, for example, for torticollis) may develop antibodies to the botulinum toxin. They do not cause a hypersensitivity reaction or anaphylaxis. However, the antibodies block the action of the toxin, making the patient resistant to further Botox treatment.
Having used botulinum toxin for over 15 years, we find its injections for the correction of hyperfunctional facial folds to be extremely safe and effective. They can be used alone or in combination with peeling, laser resurfacing or injection fillers. Patients are very satisfied.
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