“Botox” injections have become very popular all over the world and Hong Kong is no exception. There are risks and side effects however, so being well informed is essential. Here is your complete, doctor-reviewed guide to “Botox” in Hong Kong.
What is “Botox”?
“Botox” refers to a neurotoxin called Botulinum Toxin that is produced by the bacterium Clostridium Botulinum. This bacterium is found in natural environments such as soil, lakes, and forests. If one ingested the bacteria and its toxin in contaminated food, it could cause life-threatening paralysis and even death. But when purified and injected in appropriate doses into targeted parts of the body, the toxin blocks signals between nerves and muscles, and results in the muscles relaxation. Prolonged denervation can also lead to muscle atrophy (and that is how it is commonly used to reduce the size of masseters). The toxin has been used to treat a variety of muscular conditions and has been widely applied in the field of aesthetic medicine.
“Botox” is one of the commercial brands of botulinum toxin, other brands include Dysport, Xeomin etc. We use the term “Botox” with quotation marks because most people are actually referring to the toxin itself rather than the brand when they say “Botox”. As one of the earliest and largest players in the aesthetic market of botulinum toxin, the term “Botox” has become used by many as synonymous with the generic drug.
“Botox” injections for cosmetic reasons have become very popular, with almost 7.23 million treatments conducted in the United States in 2017 alone, giving it a title of “most popular non-surgical cosmetic treatment”. Many celebrities are also said to have had “Botox” to maintain a youthful look and remove wrinkles.
Common reasons to use “Botox”
“Botox” is most commonly used to reduce facial wrinkles and fine lines. It can also be useful for eye squints, migraines, excess sweating, leaky bladders, and many other medical conditions.
Here are the most common treatments for which “Botox” can be used:
- Blepharospasm (spasm of eyelids).
- Idiopathic rotational cervical dystonia (severe neck and shoulder muscle spasms).
- Chronic migraine.
- Severe primary axillary hyperhidrosis (excessive sweating).
- Strabismus (crossed eyes).
- Post-stroke upper limb spasticity.
- Detrusor (bladder wall muscle) overactivity – causing urinary incontinence.
- Hemifacial spasm.
- Masseter hypertrophy.
- Glabellar lines (frown lines between the eyebrows).
- Canthal lines (crow’s feet).
“Botox” in Hong Kong
In Hong Kong, botulinum toxin injections are performed by locally registered plastic surgeons and you can find the updated list here. Besides plastic surgeons, some dermatologists and general practitioners also offer the service. The Code of Professional Conduct of the Medical Council of Hong Kong requires that registered doctors should act within their competence, which can be assumed to exist from their qualifications as registered medical practitioners. However, a reasonable expectation from users of medical aethetic services is to understand whether a registered doctor, regardless of his/her qualification, and proficiency in undertaking basic medical procedures, is actually proficient in application of specialised medical beauty services.
After a major aesthetic treatment blunder in 2012 where a woman died, the Hong Kong government looked deeper into regulating medical aesthetic treatments. Subsequently there were several aesthetic treatment failure cases which led doctors and lawmakers to propose that beauty parlours should be regulated, with an authority set up to evaluate the suitability of the applicant, the premises and practices, and to perform regular inspections. Aggressive promotional tactics should also be banned, and centres that violate the rules should be reprimanded.
How the procedure is performed
Botulinum toxin is generally used in very small doses. It halts signals between the nerve and muscles and thus paralyzes the muscles. Botulinum toxin is administered by diluting the powder in sterile saline under aseptic technique to prepare the drug in the desired concentration. The solution is then injected to the targeted area. It takes 24-72 hours for botulinum toxin to take effect.
During the procedure, the doctor will sterilise the skin of the targeted area and then inject small amounts of botulinum toxin into the targeted region of muscles using a fine needle. The injection site should be treated gently, and recipients should not massage or rub the treated areas by themselves after treatment. Results are often visible by around 8 days.
Botulinum toxin should not be used in pregnant or lactating women, or by people who have had a previous allergic reaction to the drug or any of its ingredients.
Side effects of “Botox”
The procedure is generally well-tolerated with little side effects. The most common side effects are mild discomfort at injection site and haematoma. Other potential side effects include:
- Mild pain, local edema (fluid buildup) and/or erythema (reddening of the skin) at the injection site.
- Headache and nausea.
- Malaise – feeling generally unwell.
- Temporary paralysis of facial muscles
- Temporary upper lid or brow ptosis (drooping).
- Weakness of the lower eyelid or lateral rectus (a muscle controlling eye movement).
- Dysphagia – trouble swallowing.
- Neck weakness.
- Brachial plexopathy – a condition affecting the nerves either side of the neck and chest.
- Gallbladder dysfunction.
- Diplopia (double vision).
- Blurred vision.
- Dry mouth.
Risks of “Botox”
Although widely applied, it should be noted that botulinum toxin is a poisonous and potentially dangerous substance. When wrongly handled, it can lead to a rare but life-threatening illness called Botulism, if remain untreated, may result in respiratory failure and death.
Botulism is a notifiable infectious disease in Hong Kong under the Prevention and Control of Disease Ordinance since 2008. Different types of botulism exists, such as foodborne, infant, wound etc. Iatrogenic botulism was defined as the spread of botulinum toxin beyond injection site following its injection fo therapeutic or cosmetic purposes, and the patient develops symptoms of botulism (e.g. dysphagia, aspiration, respiratory muscle paralysis etc). Eleven probable cases of iatrogenic botulism were reported to the Centre for Health Protection (CHP) from May 27 to August 4, 2016. Investigation revealed that 10 of the 11 cases had history of botulinum toxin injection in different beauty centres in the mainland, while one claimed to have received injection in a commercial premise in Mong Kong.
Despite the risks and possible side effects of botulinum toxin, there is still a huge demand for “Botox” in the market. This makes it essential to take your time, educate yourself and find the right practitioner to perform potential “Botox” injections. Having the procedure performed by a qualified and properly-trained doctor, and using products from reputable manufacturers minimize the risks and side effects from the procedure.
Costs of “Botox” in Hong Kong
There are a number of doctors and private clinics that provide “Botox” treatment in Hong Kong. Our research shows that on average, beauty salons and clinics in Hong Kong charge anywhere between HK$3,000 and HK$10,000 per treatment.