Like so many things with pregnancy, we're told not to do Botox because there is limited data. In the case of Botox, doctors don't want to take on the liability of saying it's OK when there are no large scale clinical studies that prove that Botox is harmful to the fetus during pregnancy. On the other hand, there are also no clinical studies to prove it's safe.

"In all likelihood there is no real risk to the baby from a cosmetic Botox injection during pregnancy," says Dr. Ari S. Hoschander, F.A.C.S. "The issue is that any clinical study to test this would be considered unethical. Having said that, if one were to have gotten Botox and then found out they were pregnant at the time, it is highly unlikely that the Botox would cause any issues with the pregnancy or the baby."

That said, Hoschander notes that he would not inject Botox into a known pregnant woman. Dr. Dennis Gross, founder of Dr. Dennis Gross Skincare, agrees. "It is just not worth the risk, especially when there are other topical ingredients that you can use to boost collagen production to improve fine lines and wrinkles that have been proven to be safe to use during pregnancy."

Of course, we all assess risk differently.

"You may not need it," says Emily Oster, author of Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong and What You Really Need to Know. "But you might like it. It might be helpful for treating some medical conditions. Or you might just value the way it makes your face look. And, as a result, you might want to make a decision about continuing its use based on actual risks, not on a recommendation for caution above all else."

Oster goes on to detail a few reassuring, albeit small, studies. "We have, for example, one study of 45 patients with chronic headaches who were treated and became pregnant. There were no negative outcomes. A retrospective review of 232 exposures over 24 years showed no differences in pregnancy and baby outcomes relative to what would be expected without exposure. Beyond these, we have various individual reports and case series (like this one and this one), all of which are reassuring."

So what exactly are the risks of getting Botox during pregnancy? "There is a risk, albeit a low one, that the toxin could spread beyond the injection site and cause botulism, a rare but serious illness where the toxin attacks the body's nerves," explains Gross. He goes on to note that there are not enough studies to confirm the potential risk of small amounts of the toxin passing through the bloodstream during pregnancy.

Oster points out that there are a few case reports of mothers with botulism poisoning (not from Botox, however, since you can also get it from tainted food or heroin use), which do not suggest negative impacts on the fetus. "This is very reassuring because obviously a dose sufficient to poison the pregnant person is far, far higher and more systematic than the dose used in cosmetic or medical applications. The reassuring data is supported by general biology. Botox injections are a low concentration of a toxin and localized. It seems unlikely that they would impact the fetus."

If you're still worried, Gross explains that there is plenty you can do before and during pregnancy to help ensure smooth skin.

"Starting a consistent skin care routine prior to pregnancy will help strengthen collagen and elastin, which prolongs the effects of Botox," says Gross. "With my patients who get Botox and use a consistent skin care routine with active ingredients and daily SPF, I find that their skin looks significantly better after taking a break from Botox during pregnancy versus patients that do not use a consistent regimen."

Your best bet? Check with your doctor.