Case Information

In 2019, it was reported in the news that a lady passed away after receiving allegedly Botox in a medical clinic.

This was possibly the first reported Botox death case in Singapore and as such, it raised a number of eyebrows within the medical community because Botox has had a good safety profile and track record.

After further investigation, on 11th October 2022, it was further reported in the news that the lady suffered a cardiac arrest after injection of ethylenediaminetetraacetic acid (EDTA). There was no mention of Botox as the cause of death in the news report.

In summary, it was unlikely that Botox was the cause of death in this case.

Link to news article here

What is Botox?

Botox is a popular brand of neurotoxin in Singapore used by medical professionals to improve wrinkles and treat certain muscular conditions such as teeth grinding and eyelid spasm.

Botox stands for Botulinum Toxin and other brands exist in the market such as Dysport and Xeomin.

How does Botox work?

Botox mechanism of action works by blocking certain nerve signals that control muscle contraction and movement. This leads to the relaxation of muscles which reduces the appearance of unwanted wrinkles.

Botox can also help to slim certain muscle groups such as jaw slimming, shoulder slimming as well as calf slimming.

When injected in the underarms or palms, it can also help to reduce excessive sweating (hyperhidrosis).

Risks of Botox injections

Botox is a safe and effective treatment when performed by an experienced doctor.

Possible mild side effects and complications include:

• Pain, swelling or bruising at the site of injection
• Headache (Forehead Botox)
• Droopy eyelid or “spock” eyebrows (Forehead Botox)
• Crooked or asymmetrical smile (Jaw Botox)
• Eye dryness (Crow’s Feet Botox)

Potential life-threatening complications are very rare and related to high doses of botox injections used to treat medical conditions such as cerebral palsy and cervical dystonia.

These severe side effects may manifest as:

• Muscle weakness
• Vision problems
• Trouble speaking or swallowing
• Breathing difficulty
• Loss of bladder control

Studies have reported the toxic dose for severe side effects to be more than 6 Botox Units per Kg.

Taking an average adult female to weigh 50kg, this translates to 300 units of Botox It is extremely unlikely that a patient will require close to 300 units of Botox for Aesthetic treatments.

Summary

In the hands of an experienced doctor, Botox injections are both safe and effective.

Severe side effects are extremely rare and are associated with very high doses of Botox.