The popularity of Botox injections for facial wrinkle reduction continues to increase. In the U.S. last year alone nearly five million Botox treatments were given. And this does not include treatments for medical conditions. Like all drugs, there are side effects but they are far and few between. The most significant aesthetic one is brow or eyelid sagging from injecting too close to the eyebrow. But because Botox is a poison, dilute as it may be, some patients worry about whether there are toxic side effects such as ending up being paralyzed or even death. The good news is that there has never been a case of paralysis or death after the administration of Botox when given for aesthetic reasons. Thus, Botox has a tremendous track record of safety for an injected drug. It is so safe because of its margin of safety. It is estimated that it would take upwards of 35,000 units of Botox to be injected to cause paralysis and death. Given that the typical dose for facial wrinkle reduction is anywhere from 20 to 50 units, it is easy to see why Botox is so safe.