Are Anti-Aging Injections Dangerous? A Singaporean Doctor’s Opinion On The Recent Aesthetic Tragedy In HK


A recent death in Hong Kong has rocked the medical aesthetic world.

In November 2018, a top Hong Kong Banker from Swiss private bank Julius Baer died after presumably having undergone botox injections by a 86 year old plastic surgeon.

This raised many questions for both patients and doctors in the Singapore community.

  • Can Botox Kill? Is this the first time that Botox has caused death?
  • If a well-educated, high-earning banker can suffer from a severe botched job by an experienced plastic surgeon, is there hope for the rest of us?
  • How can we prevent Botox botched jobs?

Can Botox Kill? Is this the first time that Botox has caused death?

Unfortunately, there have been several deaths linked to Botox injections. 

The recent case in November 2018 in Hong Kong happens to be the most recent case and hits closer to home in Singapore.

In 2008, there are claims in the UK that botox causes death. 

In 2016, there also further claims that botox spreads unnecessarily to other parts of the body. 

Botox seems DANGEROUS. How did Botox get approved as a medicine in the first place?

How does Botox Work?

Botox is a brand of neurotoxin that is administered using a fine-needle.

The neurotoxin is called Botulinum Toxin, which is found in the bacteria Clostridium botulinum. This neurotoxin relaxes your muscles.

What does Botox treat?

Botulinum toxin is used to relax your muscles—typically in your forehead, in between your eyebrows, and around your eyes.

The idea is that if you temporarily block local nerve impulses to specific muscles within your face, you won’t make certain facial expressions, so you won’t form the wrinkles that come with them.

How long does Botox last?

Botulinum toxin lasts approximately 4 months on average.

It can range from 3 months to 6 months in certain individuals.

Is there more than 1 type of Botox?

Botox is actually a brand-name of botulinum toxin made by listed company Allergan.

Botox by Allergan

Other brands of botulinum toxin are Dysport and Xeomin.

Dysport in Singapore
Xeomin in Singapore

If a well-educated, high-earning banker can suffer from a severe botched job by an experienced plastic surgeon, is there hope for the rest of us?

This is the reason why Anti-Aging Injections like Botox or Fillers should NOT be trivialised. It’s a medical procedure with potential side-effects. That is why only qualified doctors are allowed to perform these treatments.

For all Medical treatments, the results are dependent on 3 factors:

  1. Doctor’s Expertise
  2. Quality of Product/Technology
  3. Patient’s medical history

Doctor’s Expertise


But in this case, we can only infer that the lack of expertise isn’t the main reason for the mishap because the doctor in question is an experienced 86-year-old plastic surgeon.

Quality of Product/Technology

We should have an in-depth look at the PRODUCT instead.

This is not the first reported case of Botox poisoning in Hong Kong/mainland China in recent years.

This might be because of “fake botox”. More than 50% of botox in China is believed to be fake or smuggled.

Real vs Fake Botox

Botox is a powerful medicine and the dosages have to be PRECISE.

In counterfeit production, a bottle of “fake botox” could contain dosage equivalent to thousands of bottles of Botox.

This may lead to severe complications, or even death, for his patient.

Patient’s Medical History

Not everyone is suitable for cosmetic injections like Botox or Fillers as certain medical conditions and chronic medications might interact adversely with these injections.

A qualified doctor always asks a detailed medical history before conducting an aesthetic treatment.

How can we prevent “botched jobs” in Singapore?

  1. Use HSA approved Medications

There are only 3 HSA approved botulinum toxin injections in Singapore: Botox, Dysport and Xeomin. 

I use these 3 brands only – this is because there is a seal of approval from HSA.

2. Have reasonable expectations on Price

Cheap botox is almost never good botox.

If the price is too good to be true, it often is. 

3. Reputation is Key.

Do your due diligence on your aesthetic doctor/dermatologist/plastic surgeon. 

There is a lot of information and reviews on doctors and clinics in Singapore.

Make an informed decision!

Questions on aesthetic treatments?

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