The Tip of the Iceberg

What the FDA's Own Data Reveals About Neurotoxin Injuries

How many people are harmed by botulinum toxin injections? The official answer is buried in a complex government database, and the truth it tells is both shocking and deeply flawed. The narrative we are sold is that serious side effects are "rare." But the U.S. Food and Drug Administration's (FDA) own numbers paint a very different picture.

I took a deep dive into the FDA Adverse Event Reporting System (FAERS), and the numbers tell a story of widespread harm that far exceeds the official safety narrative.

The Official Toll: Decades of Reports

I compiled the adverse event data for all major botulinum toxin brands from the FAERS public dashboard. While the dashboard's charts often default to showing the last 10 years, the raw data goes back decades, with some reports dating as far back as 1992. The numbers are staggering.

As of September 2025, the combined data for brands like Botox, Dysport, Xeomin, and others includes:

• 81,324 Total Adverse Event Reports

• 22,458 Reports Classified as "Serious"

• 1,854 Reports with an Outcome of "Death"

Here is the brand-by-brand breakdown, based on the data available in the FAERS Public Dashboard:

See For Yourself: How to Search the FDA's Database

Don't just take my word for it. I encourage every single person reading this to look at the data for themselves.

1. Go to the FAERS Public Dashboard: https://www.fda.gov/drugs/questions-and-answers-fdas-adverse-event-reporting-system-faers/fda-adverse-event-reporting-system-faers-public-dashboard

2. In the search bar at the top, type the name of a product, like 'BOTOX' or 'DYSPORT' and press Enter.

3. You will see the top-line numbers and charts, showing the total reports, serious cases, and deaths.

4. To read the individual case reports, scroll over the options on the dashboard and click on the "Listing of Cases by Year" tab. This will show you a table of the raw reports, and you can click on each one to read the details submitted by patients and doctors.

Three Reasons Why These Numbers Are Wrong (And the Reality is Worse)

While these numbers are alarming, the most terrifying part is that they represent only a tiny fraction of the true number of injuries. Here's why the official data is profoundly wrong:

1. Massive Underreporting is a Known Fact. As I detail in my book, The Toxin We Trust, the FAERS system is a voluntary "leaky funnel". For every one report that makes it to the FDA, countless others are lost when patients are dismissed by doctors or fail to connect their symptoms to the injections.

2. The Data is Difficult to Access. The public-facing dashboard makes it easy to see recent trends but difficult to access the full historical picture. Accessing the full, raw data files is a highly technical process, a barrier that keeps the complete story hidden from public view.

3. The FDA Disclaimer. The FDA rightfully notes that a report is not proof of causation. However, when you see tens of thousands of reports with consistent patterns of neurological and systemic symptoms all pointing back to the same class of drugs, it paints an undeniable picture of risk that is being systematically ignored.

But Aren't the Numbers Still Small? Addressing the "Drop in the Bucket" Argument

Even when presented with thousands of official reports of harm, a common response is to dismiss them. "That's just a small number," people say, "compared to the millions of procedures performed each year." While this sounds logical on the surface, this argument falls apart when you look closer.

1. The "Small" Number Isn't Small at All. As we've covered, the FAERS system is a "leaky funnel" known for massive underreporting. The FDA itself has estimated that it may capture as little as 1-10% of actual adverse events. If we apply that conservative math to the 81,000+ reports we found, the real number of injuries could range from 810,000 to over 8 million. The number isn't small; it's just mostly invisible to our broken reporting system.

2. The Severity of the Harm Changes the Equation. This isn't a conversation about a minor rash. It's a conversation about life-altering neurological illness, permanent disability, and death. It's a game of Russian Roulette. Even if the risk is statistically "low," is it an acceptable gamble for a cosmetic procedure when the cost of losing is your entire life and livelihood? When the potential side effect is a systemic poisoning, the conversation about "small numbers" is a dangerous distraction.

3. We Can't Calculate the True Risk Because the Studies Don't Exist. Finally, it's impossible to say the risk is "small" when the very studies needed to calculate that long-term risk have never been performed. As I detailed in my post, "Built on a Fragile Foundation," the original approvals were based on short-term studies that were not designed to find these kinds of systemic, long-term problems. You cannot call a risk "small" when you have never properly studied it.

Conclusion: The Data We Have is a Dire Warning

The official numbers, as flawed and incomplete as they are, are not a reassurance of safety. They are a dire warning. They are the tip of a very large and dangerous iceberg. The true toll of these toxins is far greater than we are being told, and it is hidden in plain sight, in the government's own data.

---

What are your thoughts on this?

Discussion about this post and all other topics is happening on our Community Discussion & Support page. I would love to hear your perspective and invite you to share your story or ask a question there.

Click Here to Join the Conversation