On the September 12 episode of Keeping up with the Kardashians titled “Botox and Cigarettes,” Kim crumbles under the pressure of Hollywood to remain young, vibrant, and beautiful. Kim is surrounded by people telling her she is getting older, Kris tells Kim “stress ages you” and plucks a grey hair from her head. Kendall points out to Kim the press is dubbing her a Cougar due to her recent photo shoot in the Bahamas with young pop star Justin Bieber. Khloe steps in and tries to be the voice of reason by trying to convince Kim not to go through with Botox injections.

Despite Khoe’s desperate pleas, Kim makes the decision to go in for a Botox consultation. Khloe accompanies Kim to her consultation at Lift, MD Aesthetics. At the consultation, Kim asks the doctor to explain the possible side effects of Botox injections. The doctor responds by stating to Kim, “Serious side effects are rare and the benefits of Botox outweigh the risks.” Kim decides to go through with the procedure and schedules an appointment.

After the appointment, Kim’s eyes start to swell, itch, water, and burn. The next day, Kim’s face is seriously bruised and she has developed a painful headache. With new and popular drugs such as Botox popping up often, a new question arises: what is a sufficient warning concerning the likely side effects or contraindications when using these products? Are there magic words a physician must say? Or do those seeking the Fountain of Youth simply assume the risk?

Botox is the trade name for botulinum toxin type A, which has been described by the Journal of the American Medical Association as “the most poisonous substance known.” PubMed lists a number of side effects for Botox, some of which Kim exhibits.

In May, Mark & Associates PC and McGinnis, Lochridge & Kilgore LLP announced a $15 million dollar verdict against Allergan, Inc. (a Botox producer), after a jury found the company was negligent for failing to provide sufficient warnings about potential Botox side effects. The two law firms are currently representing numerous clients who have been injured as a result of Botox injections.

The lawsuit which eventually led to a jury verdict of $15 million against Allergen, Inc., alleged Botox injections led to severe and disabling side effects. The plaintiff, an obstetrician and gynecologist, suffered botulism poisoning after receiving Botox injections and was forced to sell her medical practice as well as step down from her position as medical director at a hospital in Oklahoma City.
This is likely to be just the beginning. The firms’ next Botox trial will be the case of a 70-year-old nurse who died in 2008 after she received Botox injections to ease her neck pain. The trial is scheduled to begin in Santa Ana, California, this month.

So, what steps has the FDA taken to address possible side effects of Botox? Effective September of 2009 the FDA required producers such as Allergen, Inc. to provide safety updates and participate in the Risk Evaluation and Mitigation Strategies (REMS) program for all botulinum toxin products approved in the US, including Botox. This is designed to aid physicians and patients alike. Hopefully, this will lead to more informed doctors which in turn will lead to more informed patients.

Unfortunately, Kim Kardashian is not the only celebrity feeling the pressure to remain forever young. Demand for Botox has infiltrated the marketplace, from Hollywood starlets to average middle class America. This has created another legal problem, the demand for counterfeit Botox products.

The demand for counterfeit Botox products which contain deadly neurotoxin has encouraged the proliferation of illicit toxin producers. In August of 2009 five well known plastic surgeons, a nurse, and their office manager pleaded guilty to misdemeanor charges in federal court after admitting they ordered and used an unapproved Botox-like drug to treat more than 150 patients.

The cases against these doctors have stirred controversy because many of them said they thought the drug was legal and were duped by slick marketing tactics. The five doctors are among roughly two hundred physicians nationwide alleged to have purchased or used fake Botox.

By the end of the episode Kim vows to never go through with Botox injections again and piles on makeup to cover the bruises on her face. Her actions and words lead us to question whether the benefits of Botox outweigh the risks as Kim’s doctor suggests during her consultation.

Here’s a clip from “Botox and Cigarettes,” courtesy of Hulu.com.