Botulinum toxin risks highlight dangers of unqualified procedures; legal consequences for clinics are severe.
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Experts warn that procedures performed by unqualified individuals carry a high risk of severe complications, costly and complex treatment. In Bulgaria, dozens of women sought emergency care at Pirogov Hospital after experiencing severe adverse reactions following botulinum toxin injections between early 2025 and mid-February; seven were hospitalized with diagnosed iatrogenic botulism, a rare and life-threatening condition that can lead to respiratory failure requiring mechanical ventilation. Investigations revealed the same person, Arina Osipova, a non-medical Russian citizen without the necessary qualifications, performed all procedures, and the toxin used was illegally imported from Turkey and suspected of being adulterated. The text also discusses cases in Lithuania, including an influencer who experienced facial paralysis after receiving an injection from an unlicensed cosmetologist. Medical professionals emphasize that only licensed dermatologists or plastic surgeons should perform these aesthetic procedures, as unqualified practitioners risk causing permanent damage like scarring or loss of function. They caution against using cheap, unverified products on the black market. Legally, while botulinum toxin injections require a medical doctor in Lithuania, there are instances where non-medical specialists still perform them. Legal experts advise that both the practitioner and the clinic can face administrative fines (ranging from €390 to €2,400) or even criminal charges depending on the severity and nature of the illegal activity, stressing the need for clinics to rigorously check staff qualifications.
