The most common side effects of Botox are mild, temporary redness, swelling, or bruising at the injection site. Based on medical records, autopsy and laboratory findings, it was determined that the cause of death was anaphylaxis to the mixture of Botox and lidocaine. In my opinion, death by injection of botulinum toxin due to aesthetic treatment is highly unlikely. Logically, for botulinum toxin to cause a complication such as cardiorespiratory failure and death, a lethal dose must be administered.
This case report documents the first death associated with a mixture of Botox and lidocaine given to a woman from chronic neck and back pain. Since news of this supposedly Botox-related death went viral in Singapore, a good number of my patients have asked me if injections of botulinum toxins for aesthetic treatments can cause cardiorespiratory failure and death, as suggested by local media outlets. Until post-mortem findings and investigations are completed, speculation about the cause of death would create unnecessary fear. I will also share with you the reasons why I disagree that it was botulinum toxin that led to his death.
However, Singaporean media have reported that this young woman underwent Botox injections before her death. Pharmacovigilance data and case reports suggest that botulinum toxin may be associated with serious adverse events such as botulism, generalized paralysis, dysphagia, respiratory depression, and even death. It is unclear whether the Botox injections led to the death of this lady, as investigations and post-mortem reports yielded nothing conclusive.