
On March 8, 2019, 32-year old property agent Lau Li Ting fell into a coma after receiving botulinum toxin injections at an aesthetic clinic located around the Esplanade area. She passed away five days later and the cause of death was reported to be cardiac arrest.
This unfortunate incident has raised questions about whether botulinum toxin injections are actually safe. While the police investigates on this unusual death arising from cosmetic injections, here are some facts you need to know about botulinum toxin injections.
WHAT IS BOTOX EXACTLY?
While most people refer to botulinum toxin injections as “Botox”, the name “Botox” is actually a registered brand name under Allergen. The most common brands of botulinum toxin used by doctors in Singapore are Botox, Dysport and Xeomin.
WHAT DOES BOTULINUM TOXIN DO?
Botulinum toxin injections have a wide variety of uses aside from cosmetic purposes. Botulinum toxin is a highly purified protein derived from bacteria. It blocks the nerve’s ability to send a chemical signal to the muscles telling it to expand or contract. In other words, the muscles remain relaxed.
According to Dr YZ Tan of Mizu Aesthetic Clinic, when injected into the face, botulinum toxin can soften the appearance of lines as the muscles are relaxed. However, they can also be used to treat other concerns like muscular spasms or even excessive sweating from armpits and palms.
CAN BOTULINUM TOXIN INJECTIONS CAUSE CARDIAC ARRESTS?
Botulinum toxin was discovered in the 19th century and cosmetic uses of botulinum toxin became popular in the 90s.
In its 20 years of clinical use, no reported links have been found between botulinum injections for cosmetic uses and heart attacks. Dr YZ Tan remarks that the dosage of botulinum toxin used for cosmetic purposes are usually minute and higher dosages have been injected in children to treat ticks and muscle spasms.
Dr Melvin Tan of EPION Clinic shares that the most serious life-threatening side effects associated with botulinum toxin are related to systemic spread of the toxin leading to botulism type symptoms such as difficulty swallowing and difficulty breathing. This has been reported in higher therapeutic doses of Botulinum toxin (eg for muscle spascity), often in patients with serious underlying diseases, and very rarely occurs in lower cosmetic doses of botulinum toxin.
With every clinical treatment, some people may experience side effects. The most common would be bruising, or if the botulinum toxin is injected into the wrong muscle, can cause drooping of the muscles you don’t intend to treat.
Dr Melvin Tan comments that some other less common side effects can include headaches, double vision and facial asymmetry.

WHAT ARE THE SIGNS OF CARDIAC ARREST?
According to a study by the European Society of Cardiology, women having a heart attack will wait around 37 minutes longer than men before seeking medical attention. This is due to the fact that they’re worried about looking silly should they not be diagnosed with a heart attack.
Cardiac arrests or heart attacks, according to Cardiologist Dr Goh Ping Ping, display symptoms like shortness of breath, jaw pain, back pain, nausea, vomiting and sometimes even flu-like symptoms. As these symptoms are subtle, women often believe that they will get better soon, and do not reach out for help.
READ MORE:
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HOW CAN YOU ENSURE YOUR OWN SAFETY WHEN SEEKING BOTULINUM TOXIN INJECTIONS?
First and foremost, visit a reputable aesthetic doctor if you are seeking botulinum toxin injections. There are medical protocols in place and emergency kits at the clinics, should there be an incident. A doctor would also be able to administer medication which would be able to counter or control the effects of a cardiac arrest and perform CPR when needed.
Dr Melvin Tan of EPION Clinic shares, “Make sure you inform your doctor of your full medical history and any medications you are currently taking. Certain medications such as Aspirin can increase your risk of bruising and others such as gentamycin antibiotics for example, can increase the potency of the neurotoxins. Medical diseases that affect the muscles and nerves are contraindications. This includes Myasthenia Gravis, ALS and Lambert Eaton syndrome.”
Disclaimer: This article is not intended to be a substitute for medical advice and readers are advised to seek advice from a qualified doctor if they are considering any medical procedures. SPH Magazine Pte Ltd does not accept any liability in respect of any action taken by a reader in reliance on any recommendation contained in this article.
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