Episode 16: Can I Get Botox or Fillers When I'm Pregnant or Breastfeeding?
Can I get Botox or fillers when I'm pregnant? Let's start this one off by looking at exactly what Botox and fillers are. So Botox is one of several medications in the class that we refer to as neurotoxins or neuromodulators. And Botox is actually the trade name for a formulation of botulinum toxin, which may sound familiar because it is in fact, the same botulinum toxin that is responsible for the paralysis associated with the medical condition called botulism.
How does Botox work?
Now of course, the botulinum toxin that we're using for aesthetic purposes is minutely dosed, such that it is extremely safe. And we don't go around causing botulism to get rid of wrinkles and fine lines. What's interesting though, is that one of the famously dangerous things about botulism is the paralysis associated with the condition. And it is this same property of botulinum toxin that we take advantage for aesthetic purposes. But again, we're using extremely small doses and we are using botulinum toxin in the context of aesthetic medicine to, in a very controlled way, slow down the movement of some of the muscles of facial expression, so that they are less apt to cause wrinkles or fine lines in the face when they're moving to cause facial expression. And specific examples of this are we often use Botox on the forehead to prevent those horizontal fine lines. And when we're doing that, we're actually slowing down a muscle called the frontalis. And when we use Botox to eliminate the glabella lines between the eyebrows, we're using Botox to slow down the motion of muscles called the corrugators. And when we're using Botox next to the eyes to eliminate crow's feet, we're using the Botox to slow down the contractions of the muscle that goes around the eye, called the orbicularis oculi.
Is Botox safe during pregnancy?
So on the one hand, while we know that Botox and other neuromodulators or neurotoxins are extremely safe when they're used properly and in appropriate dosage for aesthetic purposes, we really don't have great data on what Botox or other botulinum products might do in the case of someone who's pregnant or breastfeeding. And the common sense indication is that such small doses of a medication like this would probably be harmless. However, since we don't have the data and we probably never will, because I can't really imagine anybody ethically doing that study, the recommendation is that you steer clear of Botox and other neuromodulators while you're pregnant or breastfeeding. Interestingly, Botox and these other neuromodulators do have clinical uses outside of cosmetic medicine. For example, they can be used to treat migraines and they can also be used to relieve joint spasticity in patients with paralysis.
And there actually have been studies on botulism in these patient populations when Botox was being used for medical rather than aesthetic purposes. And there were no detectable reproductive effects, but these studies were extremely small and I'm certainly not comfortable generalizing their results to the use of Botox for cosmetic purposes. So for me, and I think for most board certified plastic surgeons and dermatologists, the answer to, can I use Botox when I'm pregnant or breastfeeding, would be no.
Can I have fillers when I’m pregnant?
Now, let's go ahead and look at fillers. And I'm going to focus on the fillers that I use primarily in my practice. And those are the fillers that are based on hyaluronic acid. And these are products that you might know by the name of Juvederm or Restylane or Voluma or Vollure and products of that nature. So like I said, these are made of hyaluronic acid and hyaluronic acid is a molecule that's found naturally in the human body. So it really should be pretty safe in the context of pregnancy and breastfeeding. But again, this just has not been studied. So again, unfortunately the answer to, can I use fillers when I'm pregnant or breastfeeding, is also probably going to be no for most practitioners that you ask.
And again, I'm speaking specifically about hyaluronic acid fillers here, but I'd imagine that most people would give the same answer for pretty much any kind of filler because when it comes to something like pregnancy or breastfeeding, it's always better to be
So to put a positive spin on all this, let's just add Botox and fillers to the list, along with Champagne and sushi of things that you can look forward to after you deliver. And if you're breastfeeding, you've got to wait a bit longer for these things as well, but you'll just love your Botox and fillers that much more when you do get to have your treatments.