Getting Botox® While Breastfeeding

Thanks to today’s innovative technology and medical advances, women (and even men) can turn back the hands of time and look the way they want at any age. Going under the knife may be the quickest and most drastic way to change your look, but it comes with a hefty price tag and a higher risk of complications.

If you are a new mother, you may be enticed by visions of seemingly perfect models and catchy slogans that promise to make everything “good as new.” Restorative procedures are an attractive way to regain your lost confidence. While there’s nothing wrong with self-improvement, before undergoing any medical procedure, it is important to know what is safe for both you and your baby.

Important things to know

Like any medical procedure, getting Botox® should be a well-thought-out plan and not done on a whim. Not only is cost a factor, but there is also the challenge of finding the right doctor who is certified, trained, and compassionate. The last thing you want is to be pressured into getting a procedure done and not liking the results 100-percent.

Your doctor should know your current health status as well as consider other things such as current medications, aesthetic goals, and plans. He or she should also evaluate your facial features and advise you on what your trouble areas are. You should also be informed about what to expect during and after the procedure.

If you are unfamiliar with what Botox® really is, take time to educate yourself before diving in. Arm yourself with knowledge and bring up any questions or concerns that you may have to your doctor during your consultation.

What is Botox®?

Many of us are familiar with the plumping effects of Botox®, which smooths and evens out even the deepest wrinkles. However, only a few know what Botox® actually is and how it exerts its antiaging effects.

Firstly, Botox® is a registered brand name of a drug that contains botulinum toxin. There are other brands available on the market containing the same active ingredient but at different strengths, doses, and additional ingredients. Some other known tradenames include Dysport ® and Xeomin®.

What is botulinum toxin?

Have you have ever looked at the back of your pantry and found an old, dusty can of food that was way past its expiration date? You may have noticed the can bulging at the top or sides. 

A species of bacteria called Clostridium botulinum causes this swelling in improperly preserved canned food and is also the source of the botulinum toxin used in Botox®– although the botulinum toxin is synthesized in a lab, not in an expired can of baked beans.

Botulin toxin is classified as a potent neurotoxin. There are several types of botulinum toxins produced by C. botulinum, but the primary toxin serotype that is used in medical and cosmetic procedures is highly purified botulinum A. 

How does Botox® work?

As a neurotoxin, botulinum toxin works by irreversibly blocking nerve signals to the muscles. This prevents muscle fibers from contracting fully. Without contractions, the overlying connective tissue and skin do not form creases, which softens facial expressions and reduces line formations. Movement is restored as the muscle fibers that receive the nerve impulses are naturally broken down and repaired over time.

The injection is administered into the muscle tissue of the preplanned sites using a thin needle. Local anesthesia may be applied before injection. However, it is not entirely necessary. The effects will not be seen immediately, but you can expect to see changes within a week and will be expected to last for 3 to 4 months.

What happens in botulism?

To make things clear, being injected with Botox® does not automatically mean you now have botulism. Botulism is a type of infection that usually arises after eating contaminated food.

Despite the rarity of occurrence, botulism has a high mortality rate. There are no vaccines available to prevent the infection, but there is an antitoxin that is used to stop the spread of botulinum. Despite the administration of the antitoxin, any damage to the nerves that has already occurred cannot be restored. So, the best way to prevent botulism is to avoid possible sources of botulinum toxin and seek early treatment.

Does botulinum toxin pass into breast milk?

This is where things get a little controversial. If you are a breastfeeding mother and are considering Botox for whatever reason, it would be prudent to gather as much credible knowledge and professional opinions to weigh your options.

Several studies have been conducted that observed and recorded the way the body transports and processes the toxin while exerting its neuroinhibitory effects. Older studies deemed botulinum preparations as safe due to its local effects at the site of injection.

Newer studies have found out that in some cases, the neurotoxin can travel via nerve connections and the blood, spreading its effects to unintended organs and tissues. Currently, there is a box warning label on Botox® products alerting prescribers and patients that there is evidence of possible distant spread of toxin effect.

Unfortunately, there is no available medical data on the use of any botulinum-containing product during lactation. Based on its pharmacokinetics, botulinum is not detectable in the bloodstream after being locally injected into the skin and muscle; therefore it is not likely to end up in breast milk. It is, however, confirmed to be teratogenic, so it should not be administered during pregnancy.

Also, there has been an account of a mother who contracted botulism yet continued to breastfeed her baby without any trace of botulin toxin in either her breastmilk or the infant’s system.

Bottom line: Botox® has not been recorded to pass into breast milk. It is deemed to be safe, but there are possible and dangerous risks if spreading occurs. Most health professionals would not advise lactating women to use Botox®.

Potential issues of having Botox® while breastfeeding

While C. botulinum can naturally be found in the gut flora, soil, and even food, the effects of botulinum toxins can cause mild-to-severe disabilities and death. This is particularly true if a child contracts botulism due to their small size and underdeveloped immune nervous system.

In most cases, Botox® injections are used to treat facial wrinkles around the mouth, lips, and forehead. In a lesser-known procedure, the Botox® injection can be placed in the axillary (underarm) area to treat a condition called primary hyperhidrosis, which is characterized by excessive sweating caused by overactive sweat glands. 

Because of the proximity of the axilla to the breast, there may be a chance of traces of the botulinum toxin making its way into the nearby breast tissue. While it is not entirely certain if this migrating toxin will end up in breast milk, its effects on the nerves and muscles of a nursing mother may cause some trouble. Doctors are advised not to allow pregnant or lactating patients to undergo this procedure.

Expected Effects After Botox

 Signs & Symptoms of Botulism

  • Redness around the injection site
  • Swelling at the injection site
  • Minimal bruising at the injection site
  • Reduction of wrinkles after several days
  • Temporary and slight reduction of muscle movement and range of motion (e.g., smiling or raising your eyebrows)

 In mothers

  • Muscle weakness, including:
    • Drooping eyelids
    • Blurred vision
    • Difficulty swallowing, speaking or breathing
  • Numbness that persists several hours to days after the procedure
  • Persistent swelling with a fever*

In infants

  • Constipation (>3 days)
  • Difficulty feeding
  • Weak cry
  • Diminished facial expressions

*Botulism does not typically cause fever, however, swelling and inflammation accompanied by a fever may indicate an infection of the injection site by other pathogens.

Alternatives to Botox® while breastfeeding

Unfortunately, there is no real alternative to Botox® or other tradenames of botulinum toxin preparations. Depending on your goals and personal preferences, there are other ways to bring back a more youthful look.

Plastic and cosmetic surgery

This is the most drastic and expensive way to change your look, but it is also the most direct and effective method. 

Procedures to consider are liposuction and fat transfer, facial sculpting and contouring, cheek and chin enhancements, facelifts, neck lifts, eyelid lifts, rhinoplasty, implants, and many more.

Unlike Botox®, the effects are permanent, and there is a much longer downtime. You will need to be admitted during and after the surgery, which means less time to spend with your baby and family. Surgery also carries more risks of complications, such as infection. 

If you’re considering surgery, always consult with a certified plastic surgeon to discuss your goals and circumstances.

Dermal fillers

Like botulinum-containing injections, dermal fillers such as Juvederm® are another weapon of choice for battling fine lines and deep wrinkles. The good thing about Juvederm® is that it contains hyaluronic acid as its main ingredient, which is not only a potent antioxidant and antiaging compound, it is safe because hyaluronic acid is naturally occurring in the human body. 

Juvederm® injections can last up to a year after the first injection, which is three times longer than the effect of Botox®. Periodic booster shots will be required to maintain your look after the first injection; these are administered in smaller doses. Juvederm® is slightly more expensive than Botox®, but the difference is only around $50.

Regardless of the perceived or advertised safety of a product, it is important to note that not all doctors feel comfortable with giving pregnant or lactating women any sort of cosmetic injection, so it is best to look around for the right doctor.

Live healthily

This may seem like a no-brainer, but many of us underestimate the power of a good night’s sleep, healthy diet, and regular exercise. The majority of the body’s cellular regeneration occurs at night during sleep, so quality rest is a must to reduce stress and signs of aging.

Eating healthy can be hard at times, but vitamin supplementation can help fill in the gaps. Look for well-rounded supplements that cover your daily requirement of vitamins and minerals and pay special attention to the vitamin C and E content. 

Vitamin C is essential for collagen formation and is an antioxidant that neutralizes free radicals and boosts the immune system. Vitamin E is one of the fat-soluble vitamins and is an important component of the lipid bilayer of the skin.

Also, drink plenty of water! Staying hydrated keeps your skin supple, which prevents fine line formation. Maintain a balanced diet with a focus on protein intake. The amino acids and fat from meat serve as the building blocks for cellular repair, which contributes to the body’s overall health and composition.

Be wary of herbal products and proprietary blends since there are not FDA-approved preparations, and little is known on their effects on lactation. Always consult with your doctor before taking new medications or making drastic lifestyle changes.

Quit smoking

If you’re not a smoker, then you won’t have much to worry about. Smoking disrupts collagen synthesis and decreases blood flow to the skin. Over time, you will notice sagging skin and more wrinkles. It’s also a given that lactating women should not be smoking, to begin with, to prevent harming their infant directly through breast milk and indirectly through second-hand smoke.

Facial exercises

Celebrities and old wives’ tales alike claim that facial exercises can be done to tone the muscles of the face and give it more definition. The exercises make sense, in theory; however, it has not been proven to be effective or consistent in all people.

There is no harm in trying facial exercises, and it does provide other benefits, which include improved circulation and stress relieving. Some people claim that chewing gum is an effective way of exercising the jaw and cheek muscles to get the face in shape.

Laser treatment

Infrared light, laser resurfacing, and other treatments are viable alternatives to invasive procedures like surgery and cosmetic injections. In conjunction with a facial scrub or peel procedure, laser therapy can lighten age spots, kill acne-causing bacteria, and stimulate the underlying tissue to regenerate. 

Collagen synthesis is shown to be stimulated, which gives the face a more supple and youthful look without the need for needles and incisions. Effects are temporary as the body continually breaks down proteins and repairs itself, so regular sessions are to maintain your look.

Microneedle treatment

You may or may not have heard of this fairly new procedure, but micro needling has been making waves in the health and beauty industry. Microneedling involves the use of a special device called a derma roller. As the name suggests, it is a rolling device that is used on the skin, similar to a jade roller or other face massaging tools. 

What makes this roller unique are the tiny, thin steel needles that are embedded into the roller. While it sounds terrifying and painful, the procedure is quick, and the pain is minimal and temporary. 

The roller works by stimulating the body’s natural healing response. The thin needles can penetrate the skin without causing bleeding or significant tissue damage, but it is enough to trigger the body’s collagen synthesis and cellular regeneration. 

Microneedling causes the body to continue cellular repair beyond what the body registers as necessary. This is because our bodies will quickly heal a cut to stop bleeding. However, it does not have any inherent aim to improve the aesthetic of the scar after the wound has been healed. Wound healing is a highly practical action, while aesthetics are not of great concern to homeostasis.

Newer, younger cells are grown around cells that are not completely worn out, which prevents visible signs of aging. Improved collagen synthesis helps with reducing marks, scars, and wrinkles. Dermarollers work synergistically with skin serums and lotions, promoting better absorption to the deeper layers of the skin.

Aside from wrinkle reduction, microneedling has been shown to help with alopecia and hair loss when combined with medications such as minoxidil though the promotion of regeneration and strengthening of the scalp.

References

American Board of Cosmetic Surgery. (2014, July 22). Botox-type Injectables, Neurotoxins. Retrieved February 1, 2020, from https://www.americanboardcosmeticsurgery.org/procedure-learning-center/non-surgical/guide-botox-type-injectables/

American Society of Plastic Surgeons. (2018, March 1). New Statistics Reveal the Shape of Plastic Surgery. Retrieved February 1, 2020, from https://www.plasticsurgery.org/news/press-releases/new-statistics-reveal-the-shape-of-plastic-surgery

Bethesda (MD): National Library of Medicine (US). (2019, June 30). Botulin A. Retrieved February 3, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK501400/

CDC. (2019, August 19). Botulism. Retrieved February 1, 2020, from https://www.cdc.gov/botulism/index.html

Huizen, J. (2018, January 26). Botox and breast-feeding safety: All you need to know. Retrieved February 2, 2020, from https://www.medicalnewstoday.com/articles/320735.php

Iriarte, C., Awosika, O., Rengifo-Pardo, M., & Ehrlich, A. (2017). Review of applications of microneedling in dermatology. Clinical, Cosmetic and Investigational Dermatology, Volume 10, 289–298. doi: 10.2147/ccid.s142450

Lúquez, C., Dykes, J. K., Yu, P. A., Raphael, B. H., & Maslanka, S. E. (2010). First Report Worldwide of an Infant Botulism Case Due to clostridium botulinum type E. Journal of Clinical Microbiology, 48(3), 1017–1017. doi: 10.1128/jcm.00051-10

Mayo Clinic. (2020, January 24). Laser resurfacing. Retrieved February 4, 2020, from https://www.mayoclinic.org/tests-procedures/laser-resurfacing/about/pac-20385114

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