Botox Injection Dangers: What Happens When an Injection Goes Wrong?
In the world of “tweakments,” minimally invasive cosmetic procedures like Botox and fillers have become as routine as a facial. But what happens when a seemingly simple Botox injection goes wrong? Botox injection dangers are real, ranging from mild side effects like bruising and swelling to more severe complications, such as drooping eyelids or even difficulty swallowing. While the procedure is generally safe when performed by trained professionals, mistakes can occur, leading to unwanted outcomes. It’s crucial to understand the potential risks before deciding to undergo Botox treatment.
In January 2025, a New York-based aesthetician was arrested for allegedly administering counterfeit Botox injections to clients. Several individuals who received treatments at JGL Aesthetics reported adverse reactions, including at least one confirmed case of botulism, according to *USA TODAY*.
While complications due to Botox are low when administered in the hands of a licensed practitioner, it becomes imperative that one identifies a trusty injector, as discussed.
How do I know if this is a competent injector? Well, experts take the floor once again.
Botox is a neuromodulator injection widely used to reduce fine lines and wrinkles by temporarily relaxing facial muscles. According to Dr. Nayoung Lee, assistant professor of dermatology at NYU Langone, Botox is also FDA-approved for medical conditions such as migraines, muscular dystonias, and neurogenic bladder issues.
The active ingredient in Botox is botulinum toxin type A, a toxin derived from Clostridium botulinum. This bacterium is the same one responsible for botulism, a rare but serious condition affecting the nervous system, as noted by the U.S. Centers for Disease Control and Prevention (CDC).
Botulism typically results from consuming food contaminated with botulinum toxin or, in infants, ingesting spores of *Clostridium botulinum*. However, a lesser-known type—iatrogenic botulism—can occur when Botox spreads beyond the injection site. According to the Cleveland Clinic, this is rare and usually happens due to improper dosage or injection directly into a blood vessel.
Symptoms of botulism include double vision, slurred speech, drooping eyelids, and difficulty swallowing or breathing. As the condition worsens, muscle weakness progresses, potentially leading to paralysis of respiratory muscles, which can be life-threatening, per the CDC.
It can be treated if detected early. According to Dr. Raman Madan, director of cosmetic dermatology at Northwell Health, botulism antitoxin could neutralize the toxin in the bloodstream, so it cannot affect the nerves any further. Nevertheless, it would not reverse damage that has already occurred, meaning some effects can last for months.
Fortunately, when administered correctly using authentic materials, the risk of botulism from Botox is extremely low. The real danger arises when unlicensed individuals administer fake or improperly handled Botox injections.
Selecting a qualified Botox injector requires thorough research. Dr. Lee and Dr. Madan stress the importance of choosing a licensed medical professional with the appropriate credentials.
In most states, only licensed medical providers—including dermatologists, plastic surgeons, physician assistants, nurse practitioners, and registered nurses—can administer Botox. Some states also require non-physician injectors to work under medical supervision. In places like New York, aestheticians are not legally permitted to inject Botox.
If you are contemplating Botox at a med spa, make sure that the facility adheres to strict medical and sterility standards. Reputable med spas employ licensed professionals and use FDA-approved neuromodulators, whereas others might not utilize the same kind of safety procedures as in a physician’s office. When you are not sure, consider treatment from a licensed doctor’s office for the best safety.
