Perspectives on the Safety of Botulinum Toxin and Facial Filler Injections: A National Survey

Although both botulinum toxin and facial filler injections are safe procedures with high efficacy and patient satisfaction, it is unclear how knowledgeable the general public is about the risks of these common cosmetic, nonsurgical procedures. The goal of this study is to assess public knowledge of the risks of botulinum toxin and facial filler injection, as well as perceived comfort with various providers delivering these injections. A cross-sectional survey was performed through Amazon Mechanical Turk regarding knowledge of the risks of botulinum toxin and facial filler injection, as well as provider and location preferences among adults 18 years and older and currently residing in the United States. When asked to identify potential risks of botulinum toxin injections from a list, asymmetry, bruising, and drooping of parts of the face were correctly identified by 38%, 40%, and 49% of respondents, respectively. Asymmetry, bruising, blindness, and blood vessel clotting (vascular occlusion) were identified as risks of filler injection by 40%, 51%, 18%, and 19% of respondents, respectively. In addition, plastic surgeons were the most preferred provider for botulinum toxin and facial filler injections, preferred by 43% and 48% of participants, respectively. Although most people would consider botulinum toxin or facial filler injections, the potential risks of these procedures, especially the serious risks of facial fillers, may be poorly appreciated by the general public.