What will the Real Housewives of New York City turn to now? Botox, the popular anti-wrinkle injection that works by paralyzing facial muscles, has some scary side effects, according to the Food and Drug Administration. An investigation into Botox and other botulism-based drugs found rare side effects in 225 cases (16 of them fatal). Botulinum toxin has the potential to spread to distant parts of the body—one patient’s throat muscles were paralyzed. The side effect cases involved patients who used Botox to treat muscle spasms and none of the affected patients were taking Botox for anti-wrinkle purposes. The sellers of Botox will now have to beef up their warning labels to the black box level, the most stringent warning issued by the FDA.