[What is 'botox', what are fillers, and how safe are these cosmetic injectables?].

Botulinum neurotoxin type A (BoNT-A, popularly referred to as 'botox') is a muscle-relaxant that is injected into the mimic facial muscles to soften wrinkles in more than two percent of Dutch women annually. A similar number of women undergo filler injections with hyaluronic acid hydrogels, used to counteract the aging appearance of the skin, or to create desired facial contours. Complications are generally mild in nature and rare (certainly compared to surgical complication rates) and include nodules, bumps and a temporary heavy feeling of the eyebrows. Vascular complications related to filler injections (1:7000) can potentially lead to unilateral blindness or skin necrosis. In the Netherlands, the risk of blindness over the past six years is estimated to be 1 in every 1.4 million filler injections. Permanent skin damage due to gangrene has never been reported in the Netherlands. In conclusion, BoNT-A and hyaluronic acid filler injections are safe procedures in the hands of appropriately trained healthcare professionals.