Botox is safe when performed by a board-certified, qualified provider using FDA/COFEPRIS-approved product — most side effects are mild and temporary, while serious complications are rare and almost always tied to counterfeit product or inexperienced injectors.
In 2024, the CDC issued an alert regarding 22 people in 11 states who received Botox injections and experienced adverse effects. You may have heard of this event, as well as other anecdotes regarding botched Botox procedures.
On the other hand, you’ve seen what Botox can do, and you’re curious about trying it yourself. But there remains a question on your mind: Is Botox safe?
The Short Answer: Yes — When Done by a Qualified Provider
Botox has been approved by the FDA for cosmetic use since 2002, and it was approved for over a decade before then for therapeutic purposes. The fact is that, according to the Chameleon Pharma Consulting Group, around 10 million people in the world get Botox every year, meaning that millions of treatments are performed on a regular basis.
The key variable is provider qualifications. The CDC stat in the introduction regarding botched Botox procedures involves counterfeit Botox injections that were administered by unlicensed or untrained people in non-healthcare settings.
Botox is actually very safe when authorized products are used in trained hands, such as with Dr. Valdez. He’s a board-certified plastic surgeon with over 18 years of experience, and he did his residency at the National Autonomous University of Mexico. He was first in his class and graduated magna cum laude and summa cum laude.
We’ll give you an honest and balanced view on Botox backed by Dr. Valdez’s knowledge and experience.
Common Botox Side Effects
Botox can cause mild but temporary side effects, and all patients should expect to go through them. For example, there’s usually redness, swelling, or bruising at the injection site, but it typically resolves within hours to days.
Some people also experience a mild headache after treatment. This is common, especially with the first treatment, and it usually resolves on the same day.
You may have temporary tenderness at the injection sites. Plus, you might notice slight asymmetry in the first few days as the muscles settle.
The good news is that these side effects aren’t dangerous. They’re normal responses to any type of injection.
Less Common Side Effects
There are less common side effects that are more notable, but they’re also still temporary.
The first is drooping eyelids, or ptosis, and this can happen if Botox migrates. A case study found that this is rare among experienced injectors (under 1% of cases), but jumps to 5.4% among inexperienced injectors. It usually resolves on its own within 2-6 weeks, but it’s preventable with proper injection techniques.
Another possible side effect is a heavy brow or forehead. This is the result of over-treatment or poor Botox placement.
Some people may experience difficulty swallowing, but this is only relevant for medical Botox injections, not cosmetic treatments. This is because medical injections use much higher doses.
Lastly, you may get dry eyes or excessive tearing. This is rare, but more common in treatments near the eye area.
What Can Go Wrong With Botox? (Botox Gone Wrong)
Botox gone wrong is almost always a provider problem, not a product problem. Here are the possible botched Botox results.
Frozen or Unnatural Look
This is caused by too many units or poor placement, but it resolves as Botox wears off.
You can avoid this by choosing an experienced injector who takes a conservative, natural approach.
Drooping Eyelid
This is caused by Botox migrating beyond the injection site. It’s preventable with proper technique and aftercare (don’t rub the area).
Asymmetry
This can occur if muscles respond differently on each side. Fortunately, it’s usually correctable at a 2-week follow-up.
Forehead Botox Gone Wrong
This is an appearance of a heavy brow and loss of expression, and it’s most common when the forehead is treated in isolation without addressing the frown lines.
Experienced injectors always assess the forehead and brow together.
Rare but Serious Risks
It’s possible to have an allergic reaction to Botox, but it’s rare. Patients may have botulism-like symptoms, but this is most likely from incorrect dosing, and it’s extremely rare with cosmetic doses.
Some people may develop an infection at the injection site. Again, this isn’t common if the proper sterile technique is used.
When patients use a qualified, board-certified provider, serious complications are extremely uncommon. In fact, in 2022, Botox celebrated 20 years since its first US FDA approval, and it’s been safely used for over two decades
Long-Term Safety of Botox
We all know that Botox eventually wears off, but what about the long-term risks?
Currently, there are no significant long-term health risks from regular cosmetic Botox. Your muscles may become slightly weaker over time with repeated treatment, but that can actually be good. This reduces the units needed with each injection.
There’s no evidence of permanent nerve damage from cosmetic doses either.
How to Make Botox as Safe as Possible
Choose a Qualified Provider
One of the most important things you can do to minimize Botox risks is choose a board-certified plastic surgeon or dermatologist. In particular, they should have specific experience with facial injectables.
To make sure you’re choosing a qualified provider, ask about their training and how many treatments they perform.
Use an Approved Product
It’s imperative that you only receive FDA/COFEPRIS-approved botulinum toxin products. You should be wary of unusually cheap treatments; counterfeit products exist, as we’ve shown in the introduction stat.
Have a Proper Consultation
It’s essential that you have a proper consultation with a medical history review. Contraindications include pregnancy and neuromuscular disorders, so make sure your provider knows if you have these conditions.
The consultation can give you the opportunity for a clear discussion of goals and expected outcomes too.
Follow Aftercare Instructions
Make sure to follow your provider’s aftercare instructions carefully. In general, you should avoid rubbing the area and heat as well. Refrain from exercise for the first 24 hours too.
Why Choose a Board-Certified Plastic Surgeon Like Dr. Valdez?
Dr. Valdez has a deep understanding of facial anatomy vs. a non-medical injector. He also has the ability to manage complications if they happen.
Most importantly, he has a conservative and natural philosophy, which means that your results will look subtle yet rejuvenating.
Are you interested in getting Botox injections? Then contact us today for a consultation. Dr. Valdez specializes in facial aesthetic surgery.
References
- Are there long-term health risks to using Botox? BBC Future. May 17, 2024. Accessed July 6, 2026. https://www.bbc.com/future/article/20240503-are-there-long-terms-health-risks-to-using-botox
- Botox injections. Mayo Clinic. Accessed July 6, 2026. https://www.mayoclinic.org/tests-procedures/botox/about/pac-20384658
- CDC. How to Stay Safe When Getting Botulinum Toxin Injections. Botulism. April 22, 2026. Accessed July 6, 2026. https://www.cdc.gov/botulism/prevention/botulinum-toxin-injections.html
- Do You Know About the Long-Term Effects of Botox? Cleveland Clinic. Accessed July 6, 2026. https://health.clevelandclinic.org/long-term-effects-of-botox
- BOTOX® Cosmetic (onabotulinumtoxinA) Celebrates 20 Years Since First U.S. FDA Approval. AbbVie News Center. Accessed July 6, 2026. https://news.abbvie.com/2022-04-13-BOTOX-R-Cosmetic-onabotulinumtoxinA-Celebrates-20-Years-Since-First-U-S-FDA-Approval
- The Global Aesthetic Botox Market. Chameleon Pharma Consulting. April 15, 2024. Accessed July 6, 2026. https://www.chameleon-pharma.com/global-botox-market-in-aesthetic-medicine-exploring-growth-opportunities/
- Botulinum Toxin Type A - Product Approval Information - Licensing Action. U.S. Food and Drug Administration. Accessed July 6, 2026. https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2002/botuall041202L.htm
- CDC. Health Alert Network (HAN) - 00507: Adverse Effects Linked to Counterfeit or Mishandled Botulinum Toxin Injections. April 23, 2024. Accessed July 6, 2026. https://www.cdc.gov/han/2024/han00507.html
- Charlotte H. Wrinkles Worries: Decoding Allergy Reactions to Botulinum Neurotoxin. J Cosmet Dermatol. 2025;24(3):e70116. Accessed July 6, 2026. https://doi.org/10.1111/jocd.70116
- Nestor MS, Han H, Gade A, Fischer D, Saban Y, Polselli R. Botulinum toxin–induced blepharoptosis: Anatomy, etiology, prevention, and therapeutic options. J Cosmet Dermatol. 2021;20(10):3133-3146. Accessed July 6, 2026. https://doi.org/10.1111/jocd.14361
Frequently Asked Questions
Can Botox cause cancer?
No — there is no scientific evidence linking Botox (botulinum toxin) to cancer. Botox works locally, temporarily blocking nerve signals to the targeted muscle; it doesn't alter DNA or contain carcinogenic compounds. It has been FDA-approved for cosmetic use since 2002, and for therapeutic uses even longer, with a well-documented safety record spanning over two decades of routine use. If you have specific health concerns, your provider can review your full medical history during your consultation.
Is Botox safe long-term?
Yes — based on current research, there are no significant long-term health risks associated with regular cosmetic Botox use. With repeated treatments, the treated muscles may become slightly weaker over time, which some patients see as a benefit since it means fewer units are needed per session, and there's no evidence linking cosmetic-dose Botox to permanent nerve damage. That said, long-term data naturally covers only as long as the product has been in wide use, so choosing a provider who stays current on safety research matters.
What should I avoid after Botox to stay safe?
For the first 24 hours, avoid touching, rubbing, or massaging the treated area, since this can cause the product to migrate to unintended muscles and increase the risk of complications like eyelid drooping. It's also best to skip strenuous exercise, saunas, and direct heat exposure for the first day, and to stay upright rather than lying flat for a few hours after treatment. Your provider will give you specific aftercare instructions tailored to your treatment areas — following them closely is one of the simplest ways to reduce your risk of side effects.
Is Botox safe if I'm on blood thinners?
Blood thinners, including aspirin, warfarin, and similar medications, don't make Botox unsafe, but they do increase your risk of bruising and swelling at the injection sites. This is something you should disclose during your consultation so your provider can plan accordingly, such as adjusting injection technique. Never stop a prescribed blood thinner without your physician's guidance just to get Botox — the injection-site risk is a manageable cosmetic inconvenience, not a medical emergency.
How do I know if my Botox provider is qualified?
Look for a board-certified plastic surgeon or dermatologist with specific, documented experience in facial injectables, not just a general aesthetics certificate. Ask how many Botox treatments they perform, whether they use FDA/COFEPRIS-approved product, and whether your consultation includes a full medical history review. Be wary of unusually cheap treatments, since counterfeit or diluted product is one of the leading causes of the rare but serious complications reported in the news. Dr. Valdez, for example, is board-certified with over 18 years of experience and always uses approved product administered in a licensed medical setting.
