Front-page news: Botox injection nearly kills woman. Yesterday’s Hamilton Spectator trumpeted the news.

Does this mean that everyone who decides to smooth out a few wrinkles is risking a brush with death? Not at all.

Let’s look at what happened: Francine Giacomelli, a 25-year old woman who lived confined to a wheelchair because of severe cerebral palsy had botox injections into her thighs, hips and back to improve the function of those muscles and reduce pain.

Botox acts as a mucle relaxant, making a huge difference in conditions of severe muscle spasticity.

In this poor woman’s case, she experienced side effects from the spread of the botox so that it affected the muscles that control the eyelids and her swallowing function. She will gradually regain control of these muscles when the botox wears off but it could take months.

What about botox treatments for wrinkles?

There’s a vast difference between the way botox is used for cosmetic treatments and medical conditions.

Botox for cosmetic use is much more concentrated, meaning that it won’t travel or diffuse any distance from where it is injected. We are targeting tiny facial muscles and we want the botox to stay put.

For medical conditions, particularly those involving large muscles, the botox is diluted so that it will diffuse into the muscle. This is a good way of dealing with large muscles but it carries the risk that the botox will spread beyond the target muscle to other areas.

The dose that we use for a tiny little facial muscle is much smaller than what is needed for a big gluteal or quadriceps muscle.

When I did our Fabulous Five in the 10 Years Younger in Burlington program, the most that I put into any one woman (targeting every single facial muscle that I wanted to) was around 75 units. Not one of these ladies experienced symptoms of the botox spreading to another area.

In contrast, a lot of these medical treatments for severe spasticity start at 100 units and go up from there. I don’t know how many units this woman was given but an estimate for treating 3 large muscle groups, both left and right sides, would be a minimum of 120 units and probably a lot more.

Botox for cosmetic use in the face is very safe. There has never been a report of an allergic reaction or a death with true BOTOX® Cosmetic from Allergan.

Medical botox, on the other hand, carries risks related to the dose required, the size of the patient (the number of units per kilogram body weight is higher in children and small adults) and the part of the body being treated. However if you google botox and cerebral palsy, you will find countless reports of children and adults who experienced huge improvements in their lives, thanks to this new treatment.

I wish Francine a speedy and safe recovery.