Are Botox and Hyaluronic Acid Injections Safe?

Hyaluronic Acid

Botox, hyaluronic acid… with some 221,650 anti-wrinkle injections per year, these are the acts of aesthetic medicine most practiced in the USA. These injections of absorbable products sometimes cause reactions, depending on the product. Currently, severe side effects are between 0.1% and 1%.

Are Botox and Hyaluronic Acid Injections Safe?

Botox and hyaluronic acid are absorbable products, that is to say they are degraded naturally by the skin over time. The result is therefore transitory, but it is a guarantee of security. The risk of reaction is much lower than with a product that remains permanently in the skin. However, these two injected products do not obey the same regulations.

Botox injections: Watch out for side effects, alert a study!!!

Study reveals that botox can cause multiple complications in many patients. Its results, published in September 2021 in the Guardian, led its authors to plead for better regulation of the products used but also for the obligation for practitioners to report any complications or side effects observed. After analyzing 30 studies involving 17,352 injections of botox in the face, they indeed claim that this anti-aging treatment causes side effects in one in six patients, for an overall complication rate of around 16%.

Among the complications identified, sometimes simultaneous: bruises, headaches, nausea, “frozen” features, muscle stiffness, dizziness, dizziness and pain. In some cases, these are even cardiovascular symptoms ranging from high blood pressure to heart attacks. The study authors further found that despite the high number of incidents caused by the procedure, only 188 ‘side effects’ were reported to the UK Medicines and Health Products Regulatory Agency in the past 29 years. Last year. A figure that does not reflect reality at all according to them.

The product itself is not in question: the concern of doctors lies with people who give injections to patients without proper training. This is why they are calling for better regulation with regard to the use of “fillers.” This finding also leads them to demand that clinics administering botox be licensed and required to report observed complications as a condition of their license. In France, the French Association of Aesthetic Medicine is reassuring and indicates that there are “risks and side effects, even if the real complications and great dangers remain extremely rare. “

Botulinum toxin is a drug

This medicine has a marketing authorization. Used since the 1970s, it is a safe product. In France, three brands of this localized muscle relaxer are used in aesthetics. Only surgeons (maxillofacial surgery, face and neck surgery and reconstructive and aesthetic plastic surgery), dermatologists and ophthalmos are authorized to inject it.

Contraindication: It should not be used in people suffering from certain muscular diseases (myasthenia gravis, etc.).

Hyaluronic acid is a medical device

This large moisturizing sugar molecule, which corrects volumes, is a medical device, in the same way as breast prostheses or dressings. This invasive device (because it is injected into the skin) is therefore not considered to be a drug. It is subject to CE marking, which only guarantees the sanitary quality of the formula.

In France, around 100 products are marketed by 35 manufacturers, they are regularly checked by the National Agency for the Safety of Medicines and Health Products (ANSM), with the help of external experts. Any doctor can inject it into the face.

Contraindication: It should not be used in people who have injected with permanent products, suffering from active autoimmune diseases, and in those with keloid scars, an inflammatory scar condition.

Choosing the right practitioner

It is not always easy to choose your doctor, especially since aesthetic medicine is not recognized by the National Council of the Order of Physicians. Prefer a practitioner with specialized training. “The anatomy of the face being little studied during medical studies, certain diplomas allow doctors to learn injection techniques”, explains Dr Winter.

The practitioner should ask you about your medical history, current treatments (if you are taking anticoagulants, these injections are contraindicated). He must be informed of any previous aesthetic treatment: the injection of an absorbable product on a non-absorbable, even several years later, can cause undesirable side effects.

The practitioner must also provide you with an estimate indicating the doctor’s qualification, his registration number with the Council of the Order and the references of the products injected. This estimate must be accompanied by informed consent to sign, but also oral explanations of the precautions to be taken and any side effects.

On D-day (after 15 days of reflection), the doctor must put on gloves before pricking you, use sterile equipment, remove make-up from the skin and disinfect it. He is obliged to tell you what he has injected (name, manufacturer, batch number), and must provide you with the syringe label. If not, ask for your injection book.

“The doctor must be reachable within two or three days following the operation,” adds Dr. Martine Baspeyras. If in doubt about a reaction, send them a selfie.”

Absorbable anti-wrinkle products: what are the risks?

As with any medical act, there are some. First of all aesthetic risks, if the result does not suit. But also medical risks. According to the ANSM, the adverse effects associated with injections of hyaluronic acid affect 0.1 to 1% of people.

The most common – edema, small bleeding or bruising – subside in a few days. Rare, an allergy to hyaluronic acid exists, causing a localized inflammatory reaction such as hives. In some women, nodules may appear and create a small lump in the injected area, sometimes several months after the procedure. White blood cells attack hyaluronic acid to digest it and die. This nodule is treated by anti-inflammatory treatments based on corticosteroids and massages, or punctured.

It can also happen that hyaluronic acid is injected into an artery and mouth. “It’s the most serious complication”, underlines Dr Ludovic Lievain. It can cause skin necrosis or vascular emboli (kinds of clots). Injection with a cannula with a round tip avoids this phenomenon. These problems remain extremely rare and can be resolved if the doctor reacts right away by injecting hyaluronidase, an enzyme that dissolves hyaluronic acid. Subject to Marketing Authorization, it is authorized exclusively in the event of a vascular complication. Only surgeons, dermatologists and ophthalmologists have this antidote. “Pain, skin that turns white or blurred vision should be warning signs,” recalls Dr. Lievain.

As for the botulinum toxin, there are no cases of side effects linked to the molecule itself.

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