Medical Malpractice

Botox was first introduced approximately 20 years ago for the control of muscle spasm around the eye. When it was noticed that these patients returned a fortnight later it was noticed they all seemed to have less wrinkles. A whole wonderful application was born.

And over the past 20 years the safe uses for Botox have risen dramatically. But also the number of people injecting it - both doctors injecting this prescription-only medication legally, and the number of nurses, vets, chiropractors, beauticians and others who somehow get hold of this substance illegally - has risen dramatically.

It is paramount to your safety to ask who will be injecting your Botox.
Why? Firstly, one reason is because this is a prescription-only medication. Authorities have a responsibility to restrict access to this because it is a drug which can have severe, even fatal complications. Deaths have resulted because of injections performed primarily, if not exclusively, by people who are not doctors.

Secondly, to ensure the absolute minimum amount of drug is used to achieve the best possible result, your injector needs to have a thorough understanding of anatomy - the kind of understanding and training that only a doctor, preferably a facial surgeon can obtain. Why? Because the complex anatomy of the muscles, nerves, arteries and other structures in the face, in various depths and planes cannot be appreciated by reading this from books. And currently, only doctors and surgeons in Australia are allowed access to perform human dissection in medical school. And only doctors and surgeons are allowed to later perform surgery on live humans in hospitals under the supervision of other surgeons.

Injecting Botox and other facial injections is not something that should be done by someone who was not medically or surgically qualified. Completing a weekend course or working under the 'supervision' of a doctor who is not even on the premises is both illegal and unwise.

"There is hardly anything in the world that some man cannot make a little worse and sell a little cheaper, and the people who only consider the price are this man's lawful prey." - John Ruskin (1819-1900)

You have the right to know how much of this prescription drug is being injected. In fact, you should ask to see the prescription.

Most illegal clinics/spas/salons sell Botox by unit. However, ask them for the prescription and see what they say. Some people find it unsettling to watch them squirm as they misleadingly tell you this is not necessary, or the 'doctor' (if there is one remotely connected to them) has it in his/her clinic in another suburb. You might ask yourself, "When was the last time your pharmacist administered medication to you without you handing over this legal document?"

When you see them squirm this might be your chance to run. Fast.

Not only this, but by not giving you a copy of the prescription, allows them to give you whatever they want. Unfortunately, with the profiteering and illegal practices running this allows them to significantly dilute the Botox for a higher profit.

And, thirdly, because it is dilute, they must use a larger volume of fluid - this is dangerous. Why? Because it means they are taking an even bigger risk of this prescription drug spreading into surrounding structures in the face.

Almost every accident caused by Botox spreading into the muscles of the eye or the mouth or circulation that have resulted in paralysis or weakness of the eyelid on one side or the mouth have occurred because of unqualified or poorly trained people injecting this substance.

And, fourthly, to make matters worse, if they are not qualified doctors, then they are not insured for malpractice - after all, they are injecting illegally in the first place.

And when those people are forced to inject larger volumes, because they have diluted it with water, they also increase the risks of cross-contamination between patients.

Fifthly, additionally, the 'clinics' and spas may store the diluted Botox for long periods which decreases its effect and safety.

Ultimately, it is your job to make sure you choose a doctor who will explain the risks of Botox.

Any surgeon or doctor trained and experienced in the anatomy of the face will be able to explain, at great length, the possible (but unlikely) complications of injecting into the face. Why, because he or she has been trained in hospitals, on real patients. Many have performed surgery to repair damaged arteries or nerves. Anatomy is second nature to them. They know your face like the back of their hand. The anatomy of the face is extremely intricate. It is not something that can be mastered by studying textbooks or weekend seminars.

Botox works by reducing the movement of muscles - muscles which cause creases and wrinkles in the face. The perfect result is achieved by reducing movement enough to reduce the wrinkle while maintaining a natural expression. Hundreds of millions of Botox injections have been performed safely and it will likely be one of the most popular drugs for many years to come. But misadventures and mistakes caused by mishandling by unqualified hands is something that today's more intelligent and discerning consumers will be wise to avoid being lured into for the sake of saving a few dollars.

Dr Gary Eldridge