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Botox Injection Malpractice

Botox is one of the most common non-invasive cosmetic procedures in the country. More people are getting it every year and at younger and younger ages. With anyone from 18-year-olds coming in for Botox, many patients don’t understand the possible risks. After hearing from friends, family, Instagram models, and celebrities, it seems like it is a harmless procedure with only upsides. 

However Botox still very much remains a medical procedure. Even if most people have no problem, it is important for patients to be aware of the risks, side effects, and possible complications of Botox and cosmetic fillers. When something goes wrong during a Botox procedure, it can cause permanent damage. Patients may be left scarred, disfigured, or suffer permanent facial paralysis. 

Many injury victims fail to come forward because they blame themselves for undergoing an elective procedure. The cosmetic surgeon or medical spa may not take responsibility, blaming it on the patient or claiming it’s just a risk of the procedure. If you suffered an injury during negligent Botox procedures, you may be helping others if you come forward and hold the doctor accountable for what they did.

A medical malpractice lawsuit is also a way for you to get compensation for your injuries. Contact an experienced medical malpractice lawyer for legal advice about your Botox and cosmetic procedure injuries.

What Is Botox?

Botox is short for botulinum toxin type A. Yes, Botox is from the same toxin that causes the life-threatening type of food poisoning called botulism. However, when it is used to inject small doses of the toxin into the muscles of the face, it weakens or paralyzes facial nerves. The effect is to reduce the function of muscles that may cause wrinkling in the forehead and around the nose and eyes. 

Botox goes by many other brand names, including Dysport, Xeomin, and Jeuveau. The substance blocks the nerve signal to the muscles at the location site. The muscles are not able to contract and any contractions that result in wrinkles or skin creases are reduced over time. 

How Is Botox Used in Medical Procedures?

There are both medical and cosmetic purposes for Botox. Medical uses of Botox include: 

  • Cervical dystonia (neck and shoulder muscle contractions)
  • Chronic migraine treatment
  • Blepharospasm (uncontrolled blinking)
  • Strabismus (misaligned eyes)
  • Overactive bladder

However, most people know Botox for the elective and cosmetic procedures of temporary smoothing of facial wrinkles. Targeted areas include: 

  • Frown lines
  • Crows feet
  • Forehead wrinkles
  • Neck wrinkles
  • Lip lines
  • Gummy smiles
  • Soften jawlines

According to the American Society of Plastic Surgeons (ASPS), the average cost of Botox injections is just about $500, which makes it an attractive gateway option into cosmetic procedures. 

What Are the Risks of Botox?

When a patient goes in for a brief consultation about Botox, they may ask about risks. The salespersons usually downplay any risks, saying things like, “there are few side effects,” or, “most of the side effects are not serious.” This is a volume business. Instead, the salesperson may just push across a waiver and tell you to look it over and sign it, not giving you any real time to read it and think it over. 

Like any procedure, invasive or noninvasive, there are risks. Some of the risks of Botox treatment include:

  • Pain
  • Swelling
  • Bruising at the injection site
  • Flu-like symptoms
  • Headache
  • Nausea
  • Upset stomach
  • Drooping eyelids

Some of the more severe risks of Botox procedures include breathing problems, difficulty swallowing, muscle weakness, and slurred speech. 

Botox Statistics

According to the American Society of Plastic Surgeons (ASPS), at 4.4 million procedures, Botox was by far the most popular cosmetic minimally invasive procedure performed in 2020. There were more Botox procedures than all the top 5 cosmetic surgical procedures combined. The next most popular cosmetic minimally invasive procedure was soft tissue fillers, with 3.4 million performed. 

The number of Botox procedures will likely increase. After all, 2020 was the year the COVID-19 pandemic struck, shutting down many elective cosmetic surgical centers for months. In 2019, there were more than 5 million Botox procedures (13% higher). 

The vast majority of Botox patients were female (94% or 4.14 million), but men are increasingly opting for Botox (over 265,000). Botox patients range from all ages, with more than 12,000 13-19-year olds getting Botox in 2020. Over 64,000 20-29-year olds got Botox injections. However, the age group most likely to get Botox were 40-54-year olds, accounting for 57% of the total procedures. 

Who Can Perform Botox Procedures in the U.S.?

The laws surrounding botox procedures in the U.S. have changed over the years. Not long ago, many states considered injectables to be a non-medical procedure and didn’t require medical professionals to perform or oversee the procedures. This led to a lot of unfortunate results. Unfortunately, patients had few legal options because the people who performed the procedures were not medical professionals and were not held to a medical standard of care. 

Now, Botox laws are all over the place and vary by state law. Some states recognize the sensitive nature of these procedures and require medical professionals, doctors, or trained cosmetic surgeons to perform Botox injection procedures. Other states allow just about anybody, including recent graduates from a local esthetician program to perform Botox procedures. 

Maryland Botox Procedures 

The Maryland State Medical Society developed regulations for who could provide Botox procedures to patients in Baltimore and across the state. Botox cosmetic procedures fall under the practice of medicine and are required to be performed by a physician trained in cosmetic procedures. 

Medical professionals who perform Botox injections have to have training approved by the American Medical Association (AMA). Non-physicians who unlawfully perform these procedures may be found to be practicing medicine without a license and subject to a hefty fine. 

Pennsylvania Botox Procedures 

In Pennsylvania, only certain medical professionals can provide Botox injections to patients. This includes physicians, physician assistants (PAs), advanced practice registered nurses (APRNs), and registered nurses (RNs). 

In some cases, pharmacists may apply for authorization to administer injectables. As this is not something most pharmacists do, to be approved, they have to complete a Board-approved injectables training program, provide CPR certification, and verify they will maintain professional liability insurance of a minimum of $1 million per occurrence. 

Illinois Botox Procedures 

In Illinois, any treatments classified as medical have to be provided by a licensed medical professional. This generally includes a physician or advanced practice registered nurse (APRN). In some cases, a qualified physician assistant (PA), or registered nurse (RN) can perform Botox procedures under the supervision of a physician. 

Training and Qualifications for Licensed Cosmetic Surgeons 

Cosmetic surgeons generally have the training necessary to perform Botox and filler injections. However, with the proper training, Botox procedures can be performed by any licensed physician. When patients seek out Botox procedures, they often go directly to a multi-service medical spa or qualified plastic surgery center, to be treated under a board-certified cosmetic surgeon

Cosmetic surgeons are regular doctors (MD or DO) with the same training as other licensed doctors. However, in addition to the standard physician education and training, they have additional residency training in general surgery and plastic surgery. 

Plastic surgery is a medical specialty licensed by the American Board of Plastic Surgery (ABPS). According to the ABPS, there are more than 7,600 board-certified plastic surgeons practicing in the U.S. as of 2023. The minimum board specialty training includes 5 progressive years of clinical general surgery residency. The ABPS also requires a minimum of 3 years of plastic surgery training and 6 years for integrated programs. 

Dermatologist Training and Qualifications 

Dermatologists are doctors who undergo specialized training in conditions of the skin. Dermatologists are also considered to have the necessary training and experience to perform injectable procedures. Like other doctors, dermatologists have to go through 4 years of medical school, a 1-year internship, and 3-year residency. 

Board certification requires completing the examination and training under the American Board of Dermatology, American Osteopathic Board of Dermatology, or the Royal College of Physicians and Surgeons of Canada. Through education and residency training, dermatologists learn how to recognize and diagnose a number of skin conditions, from common to rare diseases, including performing biopsies and treating skin conditions.  

Botox Injectables and Filler Training 

Medical professionals who are not trained in injectables and fillers can undergo additional training to be able to perform Botox and related procedures. This includes educational and hands-on certification classes, to fulfill continuing medical education (CME) courses and for doctors and professionals expanding their practice. 

Many of these training classes are only 1-day courses (8-hour Botox and dermal filler certification). Depending on the state, these are available to physicians (MD and DO), registered nurses (RNs), nurse practitioners (NPs), physician assistants (PAs), and dentists (DDS and DMD). 

Medical Spa Non-Licensed Employees Providing Botox Treatment

Some less-reputable med spas allow non-physicians and non-licensed workers to perform some non-surgical medical spa procedures, including Botox fillers. In general, even if it is supervised by a doctor, these unqualified workers may be prohibited from performing these procedures. Unfortunately, unscrupulous clinic owners may be more interested in profits than safety. 

Some surgical centers rely on the relatively lower-risk filler and injectable procedures to justify allowing non-physicians to work on patients. However, when something goes wrong, it is the patient who pays the price. The clinics often get away with claiming it was just a known side effect and the patient has no recourse. Don’t rely on the word of the cosmetic procedure clinic to tell you if you have a legal case or not. If an unqualified employee caused your plastic surgery injury, the doctor behind the clinic should be held accountable. 

Treating Patients Without Informed Consent

As part of a medical procedure, doctors are supposed to get the patient’s informed consent. Informed consent means that the patient understands what the doctor is going to do, how the procedure works, and what can go wrong. Informed consent includes: 

  • Risks of treatment
  • Benefits of the procedure
  • Side effects
  • Possible complications
  • Reasonable alternatives

Once the patient understands the risks and benefits, they can make their own decision about their medical care. If the patient is not told about the risks or doesn’t understand the possible complications, how can they meaningfully agree to the procedure? 

Failure to get the patient’s informed consent can be medical malpractice. If the patient suffered a side effect that the doctor never communicated, the doctor may have failed to provide the standard medical care as required by medical standards and practices. The patient may be able to hold the doctor liable for any unexpected injuries or harm. 

Counterfeit Botox Injuries

The Food and Drug Administration (FDA) has warned consumers about possible counterfeit Botox materials being used on patients. According to the FDA, these counterfeit versions of Botox may have been sold at doctors’ offices and medical clinics by an unlicensed supplier. The fake Botox is considered unsafe and should not be used. 

Unapproved and misbranded Botox could be contaminated, adulterated, unsafe, or improperly stored, putting patients at unknown risks. 

Recovering Compensation After Botox Malpractice

If you were a victim of Botox malpractice, you may be able to recover compensation from the negligent doctor who performed the procedure. If the doctor didn’t warn you of the possible consequences, caused unanticipated facial paralysis, or unsanitary procedures led to an infection, you may have a medical malpractice case. 

If you don’t want to come forward because you’re embarrassed or blame yourself, you have nothing to feel bad about. The doctors in these clinics often sell the benefits of Botox without talking about the downsides. As medical professionals, doctors have an ethical duty to get informed consent from their patients. Lack of informed consent can be considered medical negligence. 

Damages in a medical malpractice lawsuit can help you recover money for medical bills, lost wages, the cost of corrective procedures, emotional distress, pain and suffering, and loss of enjoyment in life. Talk to a medical malpractice attorney about what happened in your case to understand how much you can receive in a Botox injury settlement.

Experienced medical malpractice lawyers, like the trial attorneys at Gilman & Bedigian, have extensive experience in cosmetic surgery malpractice injuries because they focus on just these types of cases. With the right legal team on your side, you will have the resources to help you recover damages after suffering a Botox or injectible injury. Contact Gilman & Bedigian online or at 800-529-6162 for a free consultation.

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